New research shows first pass recanalization in mechanical thrombectomy could deliver environmental benefits whilst improving patient outcomes.


Research presented at ISPOR Europe shows that achieving a rate of 40% first-pass recanalization could save as much as 536 tonnes of CO2e and 51 tonnes of waste per 10,000 patients.1 

The research was presented at ISPOR Europe, the leading European conference for health economics and outcomes research by Mesut Kocaman, EMEA Health Economics & Market Access Manager for CERENOVUS. The research findings were based on an environmental impact model developed from the post-hoc analysis of the ARISE-II clinical trial – a single-arm, prospective, multicentre study, which evaluated the efficacy and safety of EMBOTRAP® device.1

First-pass recanalization is defined as achieving recanalization after a single pass of the mechanical thrombectomy device.2 Previous studies have demonstrated that achieving complete or near complete reperfusion (modified thrombolysis in cerebral infarction (mTICI) grade 2c-3) after a single pass can result in improved clinical outcomes and have a positive impact on healthcare costs.3 

Every year, there are over 13 million stroke cases worldwide,4 and this number is set to rise by 34% by 2035.5 Across Europe, the financial cost of stroke equated to €60 billion in 2017, with €27 billion directly related to healthcare costs.6 The strong clinical benefits of first-pass recanalization have the potential to greatly reduce the economic burden of stroke,3 and now, this latest research has gone a step further by exploring potential environmental benefits.1 
This latest research showed that the decrease in resource utilisation by achieving mTICI 2c-3 after a single pass led to a 134 kg drop in CO2e and a reduction of 13 kg of waste compared to the patients who achieved the same result after multiple passes.1  

Achieving a rate of 40% of first-pass recanalization could save 536 tonnes of CO2e and 51 tonnes of waste per 10,000 patients – equivalent to carbon emissions of 2,500 round trip flights from London to Milan.1

“This research shows that first-pass recanalization not only has clinical and economic impact but has great potential benefits to the environment as well,” says Mark Dickinson, Worldwide President of CERENOVUS. “It is highly rewarding to see that this valuable metric can positively impact both the patients CERENOVUS aims to serve, and the world we live in.”


  1. Kocaman M, Taylor H. (2021). The Environmental Impact of the First Pass Effect in Mechanical Thrombectomy in the NHS. Value in Health, Volume 24, Issue 12, S2 (December 2021). 
  2. Zaidat OO, Castonguay AC, Linfante I, Gupta R, Martin CO, et al. (2018). First Pass Effect: A New Measure for Stroke Thrombectomy Devices. Stroke 49 (3): 660-666.
  3. Zaidat OO, Bozorgchami H, Ribo M, Zaidat OO, Ribo M, Mattle HP, Saver JL, Bozorgchami H, et al. (2020) Health economic impact of first-pass success among patients with acute ischemic stroke treated with mechanical thrombectomy: a United States and European perspective. Journal of Neurointerventional Surgery.  
  4. World Stroke Organization. Learn about stroke. [Accessed December 2021].
  5. Stroke Alliance for Europe. The Burden of Stroke in Europe. (2020). [Accessed December 2021].
  6. Stroke Alliance for Europe. At what cost? The economic impact of stroke in Europe. (2020). [Accessed December 2021].

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