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Stent Retriever Cuts Lifetime Costs After Stroke

— Thrombectomy expensive but pays for itself in less than 2 years

MedpageToday

Although treatment with the Solitaire stent retriever costs substantially more upfront than thrombolysis alone, the device cut long-term treatment costs, a SWIFT PRIME substudy found.

When compared to those receiving tissue plasminogen activator (tPA) only, Solitaire patients had , a pattern mostly driven by higher index hospitalization costs ($45,671 versus $28,578, P<0.001). Such patients had more emergency room visits, but fewer rehab admissions (inpatient and outpatient).

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

After discharge however, the thrombectomy group had lower costs ($11,270 versus $16,174 for tPA-only, P=0.003), , of Saint Luke's Mid America Heart Institute in Kansas City, MO, reported in a presentation at the International Stroke Conference in Los Angeles.

Looking even further down the road, the stent retriever was associated with a lifetime savings of $23,203 per patient, with 1.74 quality-adjusted life years added.

Solitaire's "economic dominance" was observed across subgroups, Shireman said, and the time it took to break even was 21.5 months.

Adding the stent retriever to tPA therapy is "highly cost-effective," she concluded.

  • author['full_name']

    Nicole Lou is a reporter for 鶹ý, where she covers cardiology news and other developments in medicine.

Disclosures

SWIFT PRIME and its economic substudy were funded by Medtronic.

Shireman disclosed relationships with the National MS Society, NIH, and Patient-Center Outcomes Research Institute.

Primary Source

International Stroke Conference

Shireman TI "Cost-effectiveness of solitaire + IV t-PA for acute ischemic stroke: results from the SWIFT PRIME trial" ISC 2016; Abstract LB21