• stroke
• thrombectomy
• device
• economics

Costs of stroke intervention are increasingly relevant as the Centers for Medicare and Medicaid Services cut payments and institutes' bundles,1 while mechanical thrombectomy (now offered within 24 hours since last known well) increases in frequency.2 3 This mismatch is likely to worsen as neurointerventional capabilities expand and results of upcoming large-core thrombectomy trials (SELECT2, TESLA, TENSION, RESCUE-Japan LIMIT, LASTE) emerge. The manuscript by Shah et al 4 therefore represents an important contribution, as little has been published on capitation of neuroendovascular devices apart from a prior manuscript from the same institution on coil costs using a theoretical capitation model.5

In their current paper, Shah et al retrospectively reviewed 364 thrombectomies performed between February 2018 and August 2019, during which they had access to capitation bundles from one company (February to September 2018), three companies (February to August 2019), or none (in-between time period). After excluding 11% of thrombectomies owing to insufficient data, they found that …