Cost Analysis of Traditional Deep Vein Thrombosis Treatment versus Inari ClotTriver

Objectives: The Inari ClotTriver is a new device approved for use in our institution as of October 2019. Our practice is at an academic center which is a level 1 trauma center with 576 beds. Traditionally, iliofemoral deep vein thrombosis (DVT) has been managed at our institution initially infusing peripheral thrombolytics overnight in the intensive care unit (ICU), followed by more aggressive intervention the following day. With the availability of the ClotTriver, we have eliminated thrombolytic drug therapy and an ICU stay. After using this new product for 1 month, we began a QI project with the objective of looking at the difference in total costs. Methods: We identified our first six ClotTriver cases and retrospectively searched for six traditionally treated DVT cases. We defined traditional cases as anyone with an iliofemoral DVT treated with an infusion catheter overnight in the ICU. These patients were then treated 24–48 h later with either balloon maceration, the Argon Cleaner device, a Penumbra catheter, or possible stenting. Intravascular ultrasound (IVUS) may or may not have been used. Since patients can stay in the hospital for days with multiple other issues, we included a 2-day stay for costs associated with the Interventional Radiology procedure. ClotTriver cases were defined as using the Inari device for iliofemoral DVTs. In addition, IVUS, balloon venoplasty, and stenting with the Venovo stent were performed if needed. These patients were on the regular medical/surgical floor. Since patients can stay in the hospital for days with multiple other issues, we included a 1-day stay for costs associated with the IR procedure. Results: Average ICU stay cost is approximately $1400 per night. Average cost for a bed on the Medical Surgical floor is $400 per night. 24 mg of TPA costs $682. The total average cost for traditional DVT treatment is $8189.60 (range 1508–20,801) as compared to the average procedure cost with the ClotTriver device at $15,628.20 (range 10,709–19,329) (P <.05). Average 2-day hospital stay for traditional patients is $12204 and 1-day stay for Inari patients $18,470.10 (P < 0.05). Two of the higher costing ClotTriver cases were bilateral DVTs. Average length of stay in traditional cases is 8.5 days (range 2–22 days). Average length of stay in ClotTriver cases is 5.8 days (range 1–8 days). Conclusion: Both parameters including procedure-related costs and ICU hospital stay in the traditional group was significantly less than compared to the ClotTriver group. However, the Inari patients' length of stay was overall less as compared to the traditional group which decreases the risk of a hospital-acquired infection. Moreover, our data show that referrer education is needed as most ClotTriver patients do not need to stay in hospital beyond 1–2 days from a DVT standpoint. As our ClotTriver patient volume increases over the next few months, we aim to present refined data with more volume.

Publication History

Article published online:
26 April 2021