Purpose: Previous studies have evaluated the safety and efficacy of the EKOS Endovascular System (BTG plc, London, United Kingdom) in the treatment of patients with pulmonary embolism (PE), but little research has been done to evaluate the cost-effectiveness of the system. The objective of this study was to determine whether the use of ultrasound-enhanced catheter-directed thrombolysis (CDT) in the treatment of PE would result in a decreased cost of stay compared with standard sidehole infusion catheters.
Materials and Methods: This is a retrospective cohort study of patients treated by CDT for a primary diagnosis of PE between August 2014 and January 2019. Patients were divided into those treated via CDT with EKOS or Cragg-McNamara catheters, and total cost of stay was compared between these two groups. Patients with a primary diagnosis other than PE were excluded from analysis.
Results: Sixty-two patients met the inclusion criteria. The average cost of stay for patients treated with the EKOS system (n = 43) was $28,909, and the average cost for patients in the standard CDT group (n = 19) was $18,791. The difference between the average cost of stay for the two groups was $10,117 (95% confidence interval [CI], $4198–$16,037; P = 0.0011). The average cost per day for patients treated with EKOS was $4415 compared with $3381 for patients in the standard CDT group. The average difference in cost per day between the two groups was $1034 (95% CI, $227–$1840; P = 0.0130).
Conclusions: Ultrasound-enhanced CDT resulted in higher cost of stay among patients treated for PE. Further research comparing overall treatment benefits of EKOS catheters with cost of stay could prove useful for hospitals seeking to establish the place of EKOS in PE treatment algorithms.