Manisha Koneru, Janet Mei, Hamza Salim, Dhairya Lakhani, Adam Dmytriw, Adrien Guenego, Dylan Wolman, Shyam Majmundar, Achala Vagal, Aakanksha Sriwastwa, Yasmin Aziz, Meisam Hoseinyazdi, Caline Azzi, Risheng Xu, Hanzhang Lu, Elisabeth Marsh, Richard Leigh, Mona Bahouth, Rafael Llinas, Kambiz Nael, Argye Hillis, Gregory Albers, Jeremy Heit, Tobias Faizy, Vivek Yedavalli
{"title":"Prolonged venous transit - where venous outflow meets financial outflow: a cost analysis.","authors":"Manisha Koneru, Janet Mei, Hamza Salim, Dhairya Lakhani, Adam Dmytriw, Adrien Guenego, Dylan Wolman, Shyam Majmundar, Achala Vagal, Aakanksha Sriwastwa, Yasmin Aziz, Meisam Hoseinyazdi, Caline Azzi, Risheng Xu, Hanzhang Lu, Elisabeth Marsh, Richard Leigh, Mona Bahouth, Rafael Llinas, Kambiz Nael, Argye Hillis, Gregory Albers, Jeremy Heit, Tobias Faizy, Vivek Yedavalli","doi":"10.1007/s00234-025-03774-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Healthcare costs in large vessel occlusion acute ischemic stroke (AIS-LVO) patients vary widely despite achieving successful reperfusion. Prolonged venous transit (PVT+) is a new marker of poor venous outflow on pretreatment perfusion imaging associated with various patient outcomes. We aim to explore the relationship between PVT + and acute care cost estimates for AIS-LVO.</p><p><strong>Methods: </strong>Adult AIS-LVO patients achieving successful reperfusion with thrombectomy at three centers in the United States were retrospectively reviewed. Cost estimates were derived from national averages for services in the Centers for Medicare and Medicaid Services data (2025). The primary outcome was total cost estimates for acute intervention, imaging, and post-treatment inpatient care until discharge. Estimates were compared between PVT + and PVT- cohorts.</p><p><strong>Results: </strong>In 109 included patients, the median age was 71 years (IQR 62-80). The cost estimates for total acute stroke care were significantly greater by $11787 in PVT + patients (median $36601 [IQR $24814-$72944] than PVT- patients (median $24814 [IQR $16956-$48388], p = 0.03). Cost of post-treatment care was significantly greater in PVT + patients than PVT- patients (p = 0.03).</p><p><strong>Conclusion: </strong>PVT + demonstrates potential as a useful, versatile pretreatment biomarker, in conjunction with other clinical data, to anticipate in-hospital resources and costs associated with acute stroke care.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03774-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Healthcare costs in large vessel occlusion acute ischemic stroke (AIS-LVO) patients vary widely despite achieving successful reperfusion. Prolonged venous transit (PVT+) is a new marker of poor venous outflow on pretreatment perfusion imaging associated with various patient outcomes. We aim to explore the relationship between PVT + and acute care cost estimates for AIS-LVO.
Methods: Adult AIS-LVO patients achieving successful reperfusion with thrombectomy at three centers in the United States were retrospectively reviewed. Cost estimates were derived from national averages for services in the Centers for Medicare and Medicaid Services data (2025). The primary outcome was total cost estimates for acute intervention, imaging, and post-treatment inpatient care until discharge. Estimates were compared between PVT + and PVT- cohorts.
Results: In 109 included patients, the median age was 71 years (IQR 62-80). The cost estimates for total acute stroke care were significantly greater by $11787 in PVT + patients (median $36601 [IQR $24814-$72944] than PVT- patients (median $24814 [IQR $16956-$48388], p = 0.03). Cost of post-treatment care was significantly greater in PVT + patients than PVT- patients (p = 0.03).
Conclusion: PVT + demonstrates potential as a useful, versatile pretreatment biomarker, in conjunction with other clinical data, to anticipate in-hospital resources and costs associated with acute stroke care.
期刊介绍:
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.