Mechanical thrombectomy is cost-effective up to 24 hours from stroke

CLAHRC researchers demonstrate the value of intervention beyond the current recommended 6 hours

Ischaemic stroke is the most common type of stroke, occurring when a blood clot blocks an artery cutting blood flow to part of the brain. Stroke can lead to coma, severe disability and eventually death if not treated promptly. 

Mechanical clot retrieval (thrombectomy) is an intervention to remove clots when the current medical treatment (thrombolysis) is not sufficient to dissolve them.

Thrombectomy to remove a clot

Current guidance from NHS England and the National Institute for Health and Care Excellence (NICE) (see below) only supports this intervention within 6 hours from stroke onset.

NHS England – Clinical Commissioning Policy on Mechanical Thrombectomy for Acute Ischaemic Stroke.

NICE – Mechanical thrombectomy devices for acute ischemic stroke. Guidance MIB153. 30 July 2018 

Our researchers compared the cost-utility of mechanical thrombectomy (MT) in addition to medical treatment versus medical treatment alone performed beyond 6 hours from stroke onset in the NHS.

Our research, published in the International Journal of Stroke, shows that MT is still cost-effective if performed up to 24 hours. The publication is now cited as health economics evidence in the latest NICE evidence review (Stroke (Update). Evidence review D: thrombectomy- Draft for consultation). and has been used to recommend the offer of MT up to 24 hours. 

The work demonstrates mechanical thrombectomy is cost-effective up to 24 hours from acute ischemic stroke symptom onset – we propose the NHS implements this intervention on the basis of improvement in the quality of life of patients as well as economic grounds.

Pizzo, E., Dumba, M., & Lobotesis, K. (2019).
Cost-utility analysis of mechanical thrombectomy between 6 and 24 hours in acute ischemic stroke.
International Journal of Stroke
https://doi.org/10.1177/1747493019830587