2026-04-17T04:04:18Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/109292025-10-24T10:32:11Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Vanden Bavière, Henri author Verma, Sanjay author Gerrits, Carin author Kokhuis, Tom author Molina Cateriano, Carlos author Ribó Jacobi, Marc author Requena, Manuel author Tomasello, Alejandro author 2024-01-29T11:32:00Z 2024-01-29T11:32:00Z 2024-02 Angiography; Stroke; Thrombectomy Angiografía; Ictus; Trombectomía Angiografia; Ictus; Trombectomia Background The ANGIOCAT trial showed a clinical benefit of direct to angiography suite (DTAS) for patients with large vessel occlusion (LVO) stroke admitted within 6 hours after symptom onset in decreased hospital workflow time and improved clinical outcome. However, the impact of DTAS implementation on hospital costs is unknown. This economic evaluation aims to assess the cost-utility of DTAS from the provider (hospital) perspective. Methods A cost-utility analysis was applied to compare DTAS with the standard direct to CT (DTCT) suite approach using direct cost and health outcomes data. The time horizon was 90 days. One-way sensitivity analysis as well as probabilistic sensitivity analysis was performed, varying the model parameters by ±25%. Measures included costs, quality-adjusted life years, and incremental cost-effectiveness ratios. Health outcomes, classified according to the modified Rankin Scale, were obtained from the ANGIOCAT trial. Respective utilities were obtained from the literature. Results DTAS is the dominant strategy. The incremental cost-effectiveness ratio is −€89 110 (−$97 600) with cost saving per patient of –€2848 (–$3120). The improved clinical outcome is directly related with a decrease in costs for the hospital, mainly due to the decrease in costs of hospital stay, improved clinical outcome and fewer complications. Conclusions For patients with LVO admitted within 6 hours after symptom onset, the DTAS not only improves clinical outcome but also decreases the costs (dominant option) compared with the standard DTCT. Multicentric international randomized clinical trials are ongoing to determine the replicability of our findings. The research was supported by Philips. http://hdl.handle.net/11351/10929 Malalties cerebrovasculars Angiografia Oclusions arterials DISEASES::Cardiovascular Diseases::Vascular Diseases::Arterial Occlusive Diseases ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Radiography::Angiography DISEASES::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Cerebrovascular Disorders::Stroke ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::arteriopatías oclusivas TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::radiografía::angiografía ENFERMEDADES::enfermedades del sistema nervioso::enfermedades del sistema nervioso central::enfermedades cerebrales::trastornos cerebrovasculares::accidente cerebrovascular Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial