Introduction/Purpose Large‐vessel occlusion ischemic stroke causes significant morbidity and mortality, with stroke accounting for 2 trillion of losses globally each year. Mechanical thrombectomy has proven to have robust outcomes but involves high procedural supply costs, and few studies have investigated these costs with high granularity and their predictors. This study analyzes aspiration‐based thrombectomy supply costs to identify predictors and opportunities for cost optimization. Materials and Methods This retrospective, single‐center study (January 2022‐June 2024) included 322 patients undergoing aspiration thrombectomy. Clinical (demographics, comorbidities, stroke details, outcomes) and financial (admission and endovascular supply costs) data were collected. Multivariable regressions assessed predictors of supply costs, stent retriever use, aspiration passes, and favorable 90‐day mRS (0‐2). Costs are presented as standardized “units”. Results Mean admission cost was 157. 30 units, with endovascular supplies contributing 25. 96% (40. 83 units), second only to ICU costs. Stent retrievers (12. 79 units) and aspiration systems (10. 95 units) were large drivers of supply cost. Higher costs were associated with stent retriever use (+20. 14 units, p<10 ‐17), aspiration catheter model, longer time to treatment (+0. 0055 units/min), and failure to reach target (+15. 61 units). Stent retriever use correlated with more passes, longer procedure duration, and aspiration catheter model. Favorable mRS (0‐2) was predicted by lower NIHSS, higher TICI, shorter treatment time, and specific aspiration catheters. Notably, aspiration catheters predictive of outcome were not predictive of cost. Conclusion Endovascular supplies significantly drive thrombectomy admission costs, and strategic device selection and aspiration‐first approaches may optimize costs without compromising outcomes. Our investigation finds that device selection, including stent retriever use and aspiration catheter model, is an optimizable cost factor independent of device performance and patient outcome. Cost‐conscious protocols and analyses can enhance resource allocation for value‐based stroke care while maintaining efficacious care. image image
Hoglund et al. (Sat,) studied this question.