Philips’ Direct-to-Angio Stroke Pathway Economic Analysis Published

June 14, 2023—Royal Philips announced the results of a health economic analysis that showed an innovative approach to the stroke care pathway reduced costs by an average of €2,848 (approximately US$3,120) per patient.

The retrospective analysis looked at data from the controlled single-center ANGIOCAT clinical trial conducted at the Vall d’Hebron University Hospital Stroke Unit in Barcelona, Spain. Earlier results from this study demonstrated that a “Direct-to-Angio Suite” (DTAS) pathway improves clinical outcomes for patients who have experienced a stroke.

Manuel Requena, MD, et al published the findings from the analysis online in the Journal of NeuroInterventional Surgery.

Dr. Requena, who is a stroke and interventional neurologist at University Hospital Vall d’Hebron, commented in Philips’ press release, “The ANGIOCAT clinical study has already shown that bringing stroke patients directly to the angio suite improves patient outcomes. The economic analysis of the data now tells us we can also significantly reduce costs. This indicates that the initial up-front investment of a DTAS workflow will result in a fast return on investment for health care providers.”

According to Philips, the typical treatment pathway for stroke patients after initial triage in the emergency department involves sending the patient to the radiology department for a diagnostic CT or MRI brain scan. This process adds time, often worsened by gaps in communication, information, and access to stroke expertise. For stroke centers, a time-saving alternative is to have a dedicated angio suite permanently on standby, to which stroke patients can be transferred immediately after admission.

Using cone-beam CT (CBCT) imaging, such as that built into Philips’ Azurion image-guided therapy system, clinicians can make a diagnosis and intervene on-the-spot, saving time. The health economics analysis indicates that a positive return on investing in a dedicated angio suite can be achieved in a few years noted Philips.

Philips’ DTAS workflow is enabled by an advanced CBCT brain scan performed directly in the angio suite to diagnose patients. CBCT utilizes a cone-shaped beam of x-rays and a flat-panel detector mounted on a C-arm gantry, capturing multiple images from different angles to reconstruct three-dimensional images of the brain.

The company stated it has increased the diagnostic confidence of CBCT from 32% to 93% in the space of a few years. This technology can rule out intracranial hemorrhages and identify large vessel occlusions (LVOs), which account for approximately 25% to 50% of acute ischemic strokes. Patients diagnosed with an LVO can then be immediately operated on using a minimally invasive image-guided mechanical thrombectomy to open the blocked artery causing the stroke.

Multiple single-center studies have shown the positive impact of DTAS on clinical outcomes with the result that many dedicated stroke centers have already adopted it. In July 2021, Philips announced the commencement of the large multicenter WE-TRUST randomized clinical trial, which is currently being conducted to confirm the benefit of DTAS.