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Cost-Effectiveness of Solitaire Stent Retriever Thrombectomy for Acute Ischemic Stroke: Results From the SWIFT-PRIME Trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke).

Stroke

February 2017

From the Center for Gerontology and Health Care Research, Brown University School of Public Health, Providence, RI (T.I.S.); Department of Cardiovascular Research (K.W., K.A.V., J.H.) and Department of Cardiology (D.J.C.), Saint Luke's Mid America Heart Institute, Kansas City, MO; Department of Neurology and Comprehensive Stroke Center (J.L.S.) and Division of Interventional Neuroradiology (R.J.), University of California Los Angeles; Departments of Radiology and Clinical Neurosciences, University of Calgary, Alberta, Canada (M.G.); Department of Neuroradiology, Hôpital Gui-de-Chauliac, Montpellier, France (A.B.); Department of Neurology, University Hospital of University Duisburg-Essen, Germany (H.-C.D.); Department of Neurosurgery, State University of New York at Buffalo (E.I.L.); Division of Neuroradiology and Division of Neurosurgery, Department of Medical Imaging and Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada (V.M.P.); Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA (G.W.A.); Department of Diagnostic and Therapeutic Neuroradiology, University Hospital of Toulouse, France (C.C.); Department of Neurology, University of Heidelberg, Germany (W.H.); Department of Radiology and Neuroradiology, Christian-Albrechts-University Kiel, Germany (O.J.); Department of Neurology, University of Pittsburgh Medical Center, PA (T.G.J., V.K.R.); Department of Neurology, Inselspital, University of Bern, Switzerland (H.P.M.); Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Department of Neurology, Emory University School of Medicine, Atlanta, GA (R.G.N.); Department of Neurosurgery, Toshiba Stroke and Vascular Research Center, University at Buffalo State University of New York at Buffalo (A.H.S.); Department of Neurology and Neurosurgery, University of Miami Miller School of Medicine, Jackson Memorial Hospital, FL (D.R.Y.); Division of Neurology, Erlanger Hospital at University of Tennessee, Chattanooga (T.G.D.); Department of Neurosurgery, Rush University Medical Center, Chicago, IL (D.K.L.); Institute of Neuroradiology, Klinikum der Goethe-Universität, Frankfurt, Germany (R.d.M.d.R.); Department of Neurology, Washington University in Saint Louis, MO (J.-M.L.); and Department of Medicine, University of Missouri-Kansas City School of Medicine (D.J.C.).

Background And Purpose: Clinical trials have demonstrated improved 90-day outcomes for patients with acute ischemic stroke treated with stent retriever thrombectomy plus tissue-type plasminogen activator (SST+tPA) compared with tPA. Previous studies suggested that this strategy may be cost-effective, but models were derived from pooled data and older assumptions.

Methods: In this prospective economic substudy conducted alongside the SWIFT-PRIME trial (Solitaire With the Intention for Thrombectomy as Primary Endovascular Treatment for Acute Ischemic Stroke), in-trial costs were measured for patients using detailed medical resource utilization and hospital billing data.

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