ABSTRACT NUMBER: ESOC2026A2430 PROCEDURAL IMPROVEMENT OF ENDOVASCULAR THROMBECTOMY IN PATIENTS WITH ACUTE ISCHEMIC STROKE ENTAILS HEALTH GAINS AND COST SAVINGS

Abstract Background and aims As standard of care for acute ischemic stroke (AIS) caused by large artery occlusions, endovascular thrombectomy (EVT) comprises a highly cost-effective intervention. The association between procedural factors and successful recanalization has been delineated for EVT. To what extent nation-level procedural improvements of EVT impact costs and health-related quality-of-life in patients with AIS remain unstudied. This work aims to determine the most cost-effective procedural configuration for EVT in patients with AIS. Methods This study modelled the cost-effectiveness of nation-level procedural improvement of EVT using data from two national-quality registries (2020, 2022, 2024). The analysis appraised both single- and multi-factor procedural effects on costs and quality-adjusted life years. It encompassed determining the most cost-effective procedural configuration to pursue for EVT in Sweden. Results If the use of general anesthesia (GA) reaches 90.0% of EVTs, it would entail annual health gains and cost savings equal to 66 QALYs and mEUR 1.6 in comparison with the use of GA in 35.6% of EVTs (2020). Corresponding estimates for increasing the use of balloon-guide catheter (BGC) from 47.7% to 90.0% of EVTs are 41 QALYs and mEUR 0.97. Likewise, phasing out contact aspiration alone for EVT from 34.1% to 10.0% induces annual gains of 21 QALYs and cost savings of mEUR 0.51. Conclusions Increasing the use of GA and BGC while minimizing the use of aspiration catheter alone lead to health gains while reducing costs. Optimization of nation-wide procedural configurations for EVT comprises a health- and cost-saving endeavor that contributes to the advancement towards equitable stroke systems of care. Conflict of interest Nicklas Ennab Vogel: nothing to disclose. Björn Hansen: nothing to disclose. Malin Rundgren: nothing to disclose. Johan Wassélius: JW is a founder and shareholder of Uman Sense AB and has received speaker honoraria from Siemens Healthineers, BALT group and Medtronic Inc.