This STE report examines the social and system demographics, technological safety and therapeutic efficacy/effectiveness, cost-effectiveness, and budget impact of endovascular therapy for acute ischemic stroke, contextualized to the Alberta setting.

Contents

• INSTITUTE OF HEALTH ECONOMICS
• IHE BOARD OF DIRECTORS
• Acknowledgements
• Executive Summary
• Abbreviations
• Glossary
• SECTION ONE. Policy Context
  • 1.1. Background
  • 1.2. Policy Question
  • 1.3. Alberta STE Evidence Assessment
• SECTION TWO. Social and System Demographics
  Susan Armijo-Olivo, Arianna Waye, and Lisa Tjosvold.
  • 2.1. Introduction
  • 2.2. Stroke and Endovascular Therapy
  • 2.3. Acute Stroke Care in Canada
  • 2.4. Emerging Developments for Acute Ischemic Stroke Treatment
  • 2.5. Additional Considerations for EVT Implementation
  • 2.6. Health System Capacity in Alberta
  • Appendix S.A. Literature Search Summary
  • Appendix S.B. Alberta Health Services EMS Stroke Screen Tool
  • Appendix S.C. Flight Times from Alberta PSCs to CSCs
  • Appendix S.D. Imaging Technology and Personnel Available in Alberta PSCs
• SECTION THREE. Technological Safety and Effectiveness
  Bing Guo, Carmen Moga, and Lisa Tjosvold.
  • 3.1. Introduction
  • 3.2. Background
  • 3.3. Description of Technology: Endovascular Therapy
  • 3.4. Description of Selected Studies
  • 3.5. Overall Safety and Efficacy of EVT
  • 3.6. Impact of Patient/Clinical Factors on EVT Effects
  • 3.7. Ongoing Clinical Trials
  • 3.8. Discussion
  • 3.9. Conclusion
  • Appendix T.A. Methodology
  • Appendix T.B. Excluded Studies and Reasons for Exclusion
  • Appendix T.C. Characteristics of Included Studies
  • Appendix T.D. Quality Appraisal of Included Studies
  • Appendix T.E. Overall Effects of EVT in Patients with Acute Ischemic Stroke
  • Appendix T.F. Impact of Patient/Clinical Factors on Clinical Outcomes
  • Appendix T.G. Eligibility Criteria
  • References
• SECTION FOUR. Economic Analysis
  Charles Yan, Yufei Zheng, and Anderson Chuck.
  • 4.1. Introduction
  • 4.2. Results
  • 4.3. Discussion
  • 4.4. Conclusion
  • Appendix E.A. Methods of the Economic Analysis
  • Appendix E.B. Results of the Economic Analysis
  • References
• Appendix A. Expert Advisory Group and Project Team
• Author Contribution Statements

Corresponding Author Please direct any inquiries about this report to Dr. Bing Guo, ac.ehi@ougb

Declared Competing Interest of Authors

Competing interest is considered to be financial interest or non-financial interest, either direct or indirect, that would affect the research contained in this report or create a situation in which a person’s judgement could be unduly influenced by a secondary interest, such as personal advancement.

The authors of this publication claim no competing interest.

Suggested citation:

Institute of Health Economics. Endovascular therapy for acute ischemic stroke. Edmonton (AB): Institute of Health Economics; 2017.

Alberta STE Report: Policy-driven Health Technology Assessment reports that include an analysis of the social and system demographics, technological effectiveness, and economic implications of a health technology. The reports are written under contract with the Alberta Health Technologies Decision Process and contextualized for use in Alberta.

This publication is available for free download from the IHE website at http://www.ihe.ca.