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Updated: Oct 4, 2025
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Cost-Effectiveness of Endovascular Thrombectomy in Childhood Stroke: An Analysis of the Save ChildS Study
Wolfgang G Kunz1, Peter B Sporns2,3, Marios N Psychogios2
1Department of Radiology, University Hospital, LMU Munich, Munich, Germany.
Insights
Endovascular thrombectomy (EVT) is a cost-saving and effective treatment for pediatric stroke patients with large vessel occlusions (LVOs). This approach significantly improves long-term health outcomes and reduces overall healthcare costs.
Area of Science:
- Pediatric Neurology
- Interventional Neuroradiology
- Health Economics
Background:
- The Save ChildS Study established endovascular thrombectomy (EVT) as a safe and effective treatment for pediatric stroke with large vessel occlusions (LVOs), achieving high recanalization rates.
- However, the long-term economic and health implications of EVT in this population remained to be determined.
Purpose of the Study:
- To evaluate the long-term cost, health consequences, and cost-effectiveness of EVT compared to standard care for pediatric stroke patients with LVOs.
- To analyze the economic impact from both healthcare and societal perspectives.
Main Methods:
- A retrospective study utilizing a decision-analytic Markov model to estimate lifetime costs and quality-adjusted life years (QALYs).
- Early outcomes were derived from the Save ChildS Study, with the standard of care group modeled using a subgroup with unsuccessful recanalization.
- Lifetime parameters were sourced from current literature, with analyses conducted from US healthcare and societal perspectives, including probabilistic sensitivity analyses.
Main Results:
- Endovascular thrombectomy (EVT) emerged as the dominant strategy, proving both cost-effective and cost-saving for pediatric stroke patients.
- EVT was associated with an additional 4.02 lifetime QALYs and significant cost savings: $169,982 from a healthcare perspective and $254,110 from a societal perspective.
- Acceptability rates for EVT were high, at 96.60% for the healthcare perspective and 96.66% for the societal perspective.
Conclusions:
- Endovascular thrombectomy (EVT) for pediatric stroke patients with LVOs leads to improved quality-adjusted life years (QALYs) and reduced long-term healthcare expenditures.
- Based on the Save ChildS Study data, EVT represents a highly cost-effective treatment strategy for childhood stroke.
Background And Purpose:
The Save ChildS Study demonstrated that endovascular thrombectomy (EVT) is a safe treatment option for pediatric stroke patients with large vessel occlusions (LVOs) with high recanalization rates. Our aim was to determine the long-term cost, health consequences and cost-effectiveness of EVT in this patient population.
Methods:
In this retrospective study, a decision-analytic Markov model estimated lifetime costs and quality-adjusted life years (QALYs). Early outcome parameters were based on the entire Save ChildS Study to model the EVT group. As no randomized data exist, the Save ChildS patient subgroup with unsuccessful recanalization was used to model the standard of care group. For modeling of lifetime estimates, pediatric and adult input parameters were obtained from the current literature. The analysis was conducted in a United States setting applying healthcare and societal perspectives. Probabilistic sensitivity analyses were performed. The willingness-to-pay threshold was set to $100,000 per QALY.
Results:
The model.
Results:
yielded EVT as the dominant (cost-effective as well as cost-saving) strategy for pediatric stroke patients. The incremental effectiveness for the average age of 11.3 years at first stroke in the Save ChildS Study was determined as an additional 4.02 lifetime QALYs, with lifetime cost-savings that amounted to $169,982 from a healthcare perspective and $254,110 when applying a societal perspective. Acceptability rates for EVT were 96.60% and 96.66% for the healthcare and societal perspectives.
Conclusions:
EVT for pediatric stroke patients with LVOs resulted in added QALY and reduced lifetime costs. Based on the available data in the Save ChildS Study, EVT is very likely to be a cost-effective treatment strategy for childhood stroke.
