ArticleCMAJ open
Mechanical thrombectomy in patients with acute ischemic stroke: a cost-utility analysis.
Open access · diamondAbstract read
In one paragraph
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 6 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 6 pooled it
4.5field-weighted citation impact, top 5% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 6 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Endovascular Treatment for Acute Ischemic Stroke: A Methodological Systematic Review of Health Economic Decision Modeling Studies.PharmacoEconomics · 2026Pooled it
- A Systematic Literature Review on the Burden of Disease for Patients With Moderate to Severe Acute Ischemic Stroke.Medicine · 2025Pooled it
- Mechanical thrombectomy for acute ischemic stroke: systematic review and meta-analysis.Einstein (Sao Paulo, Brazil) · 2022Pooled it
- Acute ischaemic stroke: a systematic review of the cost-effectiveness of emergency endovascular therapy using mechanical thrombectomy.Irish journal of medical science · 2019Pooled it
- A systematic review of economic evaluations on stent-retriever thrombectomy for acute ischemic stroke.Journal of neurology · 2018Pooled it
- Cost-effectiveness of mechanical thrombectomy within 6 hours of acute ischaemic stroke in China.BMJ open · 2018Pooled it
- Cost Effectiveness of Endovascular Thrombectomy for Large Ischemic Strokes: A US Healthcare Payer Markov Model Informed by Randomized Trials.Applied health economics and health policy · 2026Article
- Cost-effectiveness of stem cell therapy versus standard of care for acute and subacute ischemic stroke.PloS one · 2026Article
- Endovascular Thrombectomy with or without Bridging Thrombolysis in Acute Ischemic Stroke: A Cost-Effectiveness Analysis.Neuroepidemiology · 2024Article
- Cost-effectiveness of seven-days-per-week rehabilitation schedule for acute stroke patients.Cost effectiveness and resource allocation : C/E · 2023Article
- Automated CT Perfusion Imaging to Aid in the Selection of Patients With Acute Ischemic Stroke for Mechanical Thrombectomy: A Health Technology Assessment.Ontario health technology assessment series · 2020Review
- The High Cost of Stroke and Stroke Cytoprotection Research.Translational stroke research · 2017Review
- Article
- Health Technology Optimization Analysis: Conceptual Approach and Illustrative Application.MDM policy & practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 1 institution in 1 country.
Xuanqian XieHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Anna LambrinosHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Brian ChanHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Irfan A DhallaHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Timo KringsHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Leanne K CasaubonHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Cheemun LumHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Nancy SikichHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Aditya BharathaHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Vitor Mendes PereiraHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Grant StottsHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Gustavo SaposnikHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Christina O'CallaghanHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Linda KellowayHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
Michael D HillHealth Quality Ontario (Xie, Lambrinos, Chan, Dhalla, Sikich); Toronto Health Economics and Technology Assessment Collaborative (Xie), Leslie Dan Pharmacy, University of Toronto; Departments of Medical Imaging and Surgery (Krings, Pereira), University of Toronto; University Health Network - Toronto Western Hospital (Krings, Casaubon); Department of Medicine (Casaubon), Division of Neurology, University of Toronto; Stroke Outcomes Research Centre (Saposnik), St. Michael's Hospital, University of Toronto; Division of Neuroradiology (Bharatha), Department of Medical Imaging, St. Michael's Hospital, University of Toronto; Ontario Stroke Network (O'Callaghan, Kelloway), Toronto, Ont.; Ottawa Hospital Research Institute and Diagnostic Imaging - Interventional Neuroradiology (Lum), The Ottawa Hospital, University of Ottawa; Division of Neurology (Stotts), The Ottawa Hospital, Ottawa, Ont.; Department of Clinical Neurosciences (Hill), Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alta.
University Health Network · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe beneficial effects of endovascular treatment with new-generation mechanical thrombectomy devices compared with intravenous thrombolysis alone to treat acute large-artery ischemic stroke have been shown in randomized controlled trials (RCTs). This study aimed to estimate the cost utility of mechanical thrombectomy compared with the established standard of care.
methodsWe developed a Markov decision process analytic model to assess the cost-effectiveness of treatment with mechanical thrombectomy plus intravenous thrombolysis versus treatment with intravenous thrombolysis alone from the public payer perspective in Canada. We conducted comprehensive literature searches to populate model inputs. We estimated the efficacy of mechanical thrombectomy plus intravenous thrombolysis from a meta-analysis of 5 RCTs, and we used data from the Oxford Vascular Study to model long-term clinical outcomes. We calculated incremental cost-effectiveness ratios (ICER) using a 5-year time horizon.
resultsThe base case analysis showed the cost and effectiveness of treatment with mechanical thrombectomy plus intravenous thrombolysis to be $126 939 and 1.484 quality-adjusted life-years (QALYs), respectively, and the cost and effectiveness of treatment with intravenous thrombolysis alone to be $124 419 and 1.273 QALYs, respectively. The mechanical thrombectomy plus intravenous thrombolysis strategy was associated with an ICER of $11 990 per QALY gained. Probabilistic sensitivity analysis showed that the probability of treatment with mechanical thrombectomy plus intravenous thrombolysis being cost-effective was 57.5%, 89.7% and 99.6% at thresholds of $20 000, $50 000 and $100 000 per QALY gained, respectively. The main factors influencing the ICER were time horizon, extra cost of mechanical thrombectomy treatment and age of the patient.
interpretationMechanical thrombectomy as an adjunct therapy to intravenous thrombolysis is cost-effective compared with treatment with intravenous thrombolysis alone for patients with acute large-artery ischemic stroke.
Identifiers
What OpenQuestion holds
Textmetadata
Read underepoch 390
Registered trials
None linked
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.