Cost-effectiveness of magnetic resonance carotid plaque imaging for primary stroke prevention in Canada

The British Journal of Radiology
Eli LechtmanPascal N Tyrrell

Abstract

Magnetic resonance of the carotid arteries provides important insight into plaque composition and vulnerability in addition to the traditional measure of stenosis. The purpose of this study was to evaluate the cost-effectiveness of MR imaging as a first-line modality to assess carotid disease and guide management for high-risk patients with <50% stenosis. Using TreeAge Pro, a cost-effectiveness simulation was conducted comparing two strategies: (a) standard of care first-line carotid duplex ultrasound (DUS) with regular follow-up, vs (b) first-line MR assessment of stenosis and intraplaque haemorrhage (MRIPH) in which patients with IPH received annual DUS surveillance and immediate carotid endarterectomy in case of plaque progression. For patients aged 70 years old, using a first-line MRIPH strategy resulted in a 16.8% relative risk reduction in strokes compared to DUS (0.080 vs 0.097 strokes per patient per lifetime), and an increased quality-adjusted-life years (12.23 vs 12.20) at an increased cost of $897.33 over a patient's lifetime ($5784.53 vs $4887.20 average total cost per patient per lifetime). The incremental cost-effectiveness ratio was $29,744 per quality-adjusted-life years. MRIPH remained cost-effective below a wi...Continue Reading

References

Oct 2, 1998·Stroke; a Journal of Cerebral Circulation·L T SmurawskaJ W Norris
Feb 10, 1999·Journal of Vascular Surgery·S C MulukM S Makaroun
Dec 3, 1999·Stroke; a Journal of Cerebral Circulation·G W PettyD O Wiebers
Nov 20, 2002·Archives of Internal Medicine·Malcolm R LawNicholas J Wald
Mar 28, 2003·BMC Health Services Research·Judith A O'BrienJ Jaime Caro
Apr 11, 2006·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Ian Shrier, Russell Steele
Jul 21, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Patrick W Sullivan, Vahram Ghushchyan
Aug 15, 2006·Health Technology Assessment : HTA·J M WardlawJ Best
Mar 17, 2007·Stroke; a Journal of Cerebral Circulation·Bertine M B GoessensYolanda van der Graaf
Mar 8, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A L Abbott, G A Donnan
Sep 18, 2008·Radiology·Richard BitarRobert Maggisano
Dec 9, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·B Ahmed, H Al-Khaffaf
Feb 5, 2010·JACC. Cardiovascular Imaging·Aloke V Finn, Rakesh K Jain
Sep 28, 2010·Lancet·Alison HallidayUNKNOWN Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group
Nov 3, 2010·Annals of Internal Medicine·James V FreemanMintu P Turakhia
May 5, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·David J CohenA Pieter Kappetein
Oct 9, 2012·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Nicole MittmannMike Sharma
Nov 17, 2012·Journal of Vascular Surgery·Gerrit L Ten KateArend F L Schinkel
Apr 26, 2013·Frontiers in Psychology·Snehlata Jaswal
Dec 3, 2014·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·A Ross Naylor

❮ Previous
Next ❯

Citations

Mar 20, 2021·Journal of the American College of Cardiology·Pier Sergio SabaAntonello Ganau

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.