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SHR Neuro Cancer Cardio Lipid Metab Microb

Hendrix, P; Killer-Oberpfalzer, M; Broussalis, E; Melamed, I; Sharma, V; Mutzenbach, S; Pikija, S; Collins, M; Lieberman, N; Hecker, C; Goren, O; Zand, R; Schirmer, CM; Trinka, E; Griessenauer, CJ.
Outcome Following Mechanical Thrombectomy for Anterior Circulation Large Vessel Occlusion Stroke in the Elderly.
Clin Neuroradiol. 2022; 32(2): 369-374. Doi: 10.1007/s00062-021-01063-9
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Pikija Slaven
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Abstract:
BACKGROUND: Pooled data of randomized controlled trials investigating mechanical thrombectomy (MT) to treat anterior circulation large vessel occlusion have demonstrated safety and effectiveness across all age groups, including ≥ 80 years of age; however, only a few nonagenarians were in the ≥ 80 years subgroup. Therefore, the benefit of MT in nonagenarians is mostly unknown. METHODS: Two comprehensive stroke centers retrospectively reviewed all acute ischemic stroke patients who underwent MT for anterior circulation large vessel occlusion (LVO) stroke between February 2016 and August 2020. Revascularization TICI2b/3, symptomatic intracranial hemorrhage (ICH), and functional outcome using modified Rankin scale (mRS) were assessed for cases aged < 80 years, 80-89 years, and 90-99 years. Favorable functional outcome was defined as mRS 0-2 or reaching the prestroke mRS and moderate as mRS 0-3. RESULTS: The final data set comprised a total of 736 cases. Of these, 466 aged < 80 years, 219 aged 80-89 years, and 51 aged 90-99 years. In nonagenarians, TICI 2b/3 revascularization was observed in 84.3% while symptomatic ICH was observed in 4%. These rates were similar to 80-89 years and < 80 years age groups. Favorable and moderate functional outcome as well as death rates differed significantly between nonagenarians and < 80 years (19.6%, 29.4%, 51.0% vs 47.9%, 60.7%, 18.7%, respectively, p < 0.001), but were similar between nonagenarians and octogenarians (29.7%, 38.8%, 38.8%, p = 0.112-0.211). CONCLUSION: A moderate outcome among nonagenarians was observed in about 30%, while mortality rates were about 50%. Withholding mechanical thrombectomy does not appear justifiable, although the absolute treatment effect among nonagenarians remains unknown.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Arterial Occlusive Diseases - administration & dosage
Brain Ischemia - therapy
Humans - administration & dosage
Intracranial Hemorrhages - administration & dosage
Ischemic Stroke - administration & dosage
Retrospective Studies - administration & dosage
Stroke - administration & dosage
Thrombectomy - administration & dosage
Treatment Outcome - administration & dosage

Find related publications in this database (Keywords)
Mechanical thrombectomy
Nonagenarians
Stroke
Cerebral ischemia
Elderly
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