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1ISG-021 1 Year-review of the Ekosonic® endovascular system (Boston Scientific) in the management of pulmonary embolism in an interventional cardiology department
  1. E Moguez
  1. Orléans University Hospital Centre, Pharmacy, Orléans, France


Background and Importance Since September 2022, the EkoS (Boston Scientific) percutaneously inserted thrombolysis catheter has been used in interventional cardiology at the Orléans Regional Hospital Centre for the treatment of intermediate-risk or severe pulmonary embolisms (PE). This medical device (MD) enables in situ administration of actilyse, whose diffusion within the thrombus is promoted by the application of ultrasound. It is an expensive medical device that is not currently reimbursed.

Aim and Objectives The aim of this work is to collect the indications of patients treated, the therapeutic protocol (TP) used and to assess the financial impact of Ekos on their stays.

Material and Methods Over the period from September 2022 to August 2023, indications, clinical contexts and TPs were collected from patient records. A literature review was carried out on the recommended TP. A cost analysis was carried out, taking into account the EKOS and associated actilyse, and the medical information department (MID) was contacted for all PMSI data.

Results Six patients were treated, with a sex ratio M/F = 4/2 and a median age of 69. The indication of high-intermediate-risk bilateral pulmonary embolism was found in all patients, with two catheters used for each; no complications following their use were found. The TPs used indicate an administration of 6mg during 6h per catheter. With regard to financial data, the cost of the technique was €6,300 excluding VAT (€3,000/catheter and €150/actilysis vial). The coded main diagnosis was PE for all patients. Fibrinolysis procedures and the associated diagnosis of heart failure (always present when fibrinolysis is indicated) were found for only two patients. An intensive care package is associated with each patient. In total, the average amount received was €6,453 per stay. A simulation was carried out with the MID in order to improve the coding: the value of the stay could then amount to €12,898.00 i.e. double the initial amount.

Conclusion and Relevance EKOS is used for the indications specified by the manufacturer. The TP may evolve in line with new publications. At present, the amount allocated per stay does not cover the technique used. In the context of healthcare cost control, optimised coding will enable us to continue using EKOS at this hospital in the future.

Conflict of Interest No conflict of interest.

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