The effects of introducing balloon dilatation into vascular surgical practice.

The numbers of angiograms, balloon dilatations, reconstructive operations and amputations carried out annually over a 5-year period following the introduction of balloon dilatation have been counted and the change in estimated costs calculated. Over the 5-year period the numbers of angiograms and reconstructive operations carried out have doubled and the number of amputations has fallen from 52 in the first year to 39 in the fifth year. The number of dilatations has increased from six in five patients in the first year to 97 in 75 patients in the fifth year. The cost of investigation and treatment has doubled but since more patients are being treated effectively, the mean cost per patient treated has fallen from pounds 1855 to pounds 1277. The introduction of balloon dilatation into vascular practice causes patients to be investigated earlier in the progress of their disease and enables more patients to be treated effectively with greater cost-efficiency, but does not reduce the overall cost of investigation and treatment of ischaemic disease of the lower limb.