Feb 26, 2017

“Economically Dominant”: Study Finds New Stroke Treatment Helps Save Money Over the Long Term

Recovery for patients like Viet Le is only part of the story.

The first time it happened to Viet Le was bad enough. The second time produced the worst kind of déjà vu.

“Things were going in slow motion again and I remember thinking ‘it can’t be the same thing,’” he said.

But it was.

Twice in nine months, both times while working out, Viet suffered massive strokes. He couldn’t stand or speak to tell bystanders what was wrong. 

Each time, doctors treated him with a combination of a clot-dissolving drug called IV-tPA and a Medtronic device called the Solitaire stent retriever. Many factors can impact an outcome, but for Viet, IV t-PA and the Solitaire stent retriever allowed him to return to functional independence.

“The technology is amazing,” Le said. “I was back at work within two months.”

The Solitaire stent retriever is inserted through the groin and guided into the brain. When deployed, it can capture stroke-causing blood clots and pull them out. See how the Solitaire stent retriever works.

Studies have found that stroke patients like Viet, who receive IV-tPA plus the Solitaire stent retriever, spend less time in the hospital, need less rehab, live longer and have a better quality of life moving forward than stroke patients treated with drugs alone.

Learn more: SWIFT-PRIME study, ESCAPE study, REVASCAT study, MR. CLEAN study, EXTEND-IA study.

And now, there’s evidence stent retriever therapy can also provide long-term health care cost savings. Learn more about the cost-effectiveness research.

A consortium led by researchers at Brown University, the University of Kansas and UCLA recently compared the long term medical and rehabilitation bills of stroke patients. Some received only drug therapy to treat their stroke, while others received stent retriever therapy in addition to drugs.

The findings concluded that over a stroke patient’s lifetime, stent retriever therapy plus IV-tPA is “economically dominant,” a term not often used in healthcare.

“It means not only does the therapy improve patient outcomes, it also saves the health system money. That’s what this treatment does,” said Dr. Jeffrey Saver, Professor and SA Vice-Chair of Neurology at the UCLA Comprehensive Stroke Center and co-author of the study.

Over the lifetime of the patient, Dr. Saver’s research estimates that health systems save an average of $23,000 per stroke patient, in cases where stent retrieval therapy is appropriate and combined with drug treatment. 

"This is as cost effective an intervention as I can imagine," Dr. Saver said.

And that's not all.

Dr. Saver’s team did not study other potential economic benefits that come with better outcomes for stroke patients, such as continued wages and worker productivity. Dr. Saver said that while studies would be necessary to confirm additional economic benefits, he thinks they could be potentially significant. “The finding here of savings from a health systems perspective is gratifying but it underestimates the true economic impact of this therapy,” he said. 

Viet sees those benefits. After doctors determined a lesion in his carotid artery was causing the blood clots which triggered his stroke, they treated that with a stent. He’s now a regular at the gym again, running, swimming and playing tennis. And rather than being disabled, he’s back at work, teaching middle school math.

“I’m contributing to society and I’m helping these kids,” he said. “I love helping kids with their math problems and math skills.”

That’s a benefit that can’t be measured.


Read the Medtronic Perspective on Transforming Healthcare:
Transforming Medtronic to Support Progress in Healthcare (PDF)



Federal (USA) law restricts this device to sale distribution and use by or on order of a physician.  Indications, contraindications, warnings and instructions for use can be found in the product labeling supplied with each device.


The Solitaire™ 2 Revascularization Device is indicated for use to restore blood flow in the neurovasculature by removing thrombus for the treatment of acute ischemic stroke to reduce disability in patients with a persistent, proximal anterior circulation, large vessel occlusion, and smaller core infarcts who have first received intravenous tissue plasminogen activator (IV t-PA). Endovascular therapy with the device should be started within 6 hours of symptom onset.

The Solitaire™2 Revascularization Device is indicated for use to restore blood flow by removing thrombus from a large intracranial vessel in patients experiencing ischemic stroke within 8 hours of symptom onset. Patients who are ineligible for IV t-PA or who fail IV t-PA therapy are candidates for treatment.


  • Bruising and bleeding at the puncture site
  • Blockage, puncturing, tearing or spasms of the blood vessel
  • Blood clot formation outside the artery
  • Post procedure bleeding
  • Change in mental status
  • Neurologic deterioration including stroke and death
  • Infection
  • Adverse reaction to blood thinners or contrast media
  • Deformation, collapse, fracture or malfunction of the device
  • Bleeding within the skull
  • Interruption of blood flow to the heart or other organs
  • Blood clotting or air bubbles within the circulatory system
  • Formation of an abnormal connection between an artery and a vein
  • Distal embolization including to a previously uninvolved territory


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