Introduction Treating with mechanical thrombectomy Low ASPECTS score (3–5) patients improve the prognosis and Rankin score. Results have been published in three recent clinical trials and furthermore are to be published regarding this specific group of patients.

Further studies should determine the economic viability of expanding the indication to Low ASPECTS score patients.

Aim of Study To demonstrate, by a cost-effectiveness analysis, the efficiency of mechanical thrombectomy (MT) versus medical management (MM) in patients with a low ASPECTS Score from the RESCUE Study.

Methods A cost-effectiveness model was designed to project both direct medical costs and quality-adjusted life-years (QALYs) of MT versus MM in eight European countries (Spain, UK, France, Italy, Belgium, Germany, Sweden, and the Netherlands). Our model was created based on previously published health-economic data in those countries. Procedure costs, acute, mid-term, and long- term care costs were projected based on expected modified Rankin Scale (mRS) scores as reported in the RESCUE- Japan LIMIT trial.

Results MT was found to be a cost- effective option in eight different countries across Europe with a lifetime incremental cost- effectiveness ratio varying from US$2 875 to US$11 202/QALY depending on the country. A cost-effectiveness acceptability curve showed 100% acceptability of MT at the willingness to pay (WTP) of US$40 000 for the eight countries.

Conclusion MT is efficient versus MM alone for patients with low ASPECTS in eight countries across Europe. Patients with a large ischemic core could be treated with MT because it is both clinically beneficial and economically sustainable.

Disclosure of Interest Nothing to disclose.