The comparison of mechanical thrombectomy and symptomatic therapy on early outcome of acute ischemic stroke in patients older than 80 years: A retrospective cohort study

Multiple randomized trials have confirmed that endovascular thrombectomy (ET) is an effective treatment method for patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). However, patients older than eighty years of age show worse functional outcomes and higher mortality ra...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2022-10, Vol.221, p.107378-107378, Article 107378
Main Authors: Ahmetović, Hana, Jerković, Ana, Vidaković, Maja Rogić, Košta, Vana
Format: Article
Language:English
Subjects:
Acute ischemic stroke
Age
Blood pressure
Cardiovascular system
Cerebral blood flow
Cerebral infarction
Clinical trials
Cohort analysis
Data analysis
Endovascular thrombectomy
Hospitalization
Hypertension
Infections
Ischemia
Mortality
Older adults
Older people
Outcome
Patients
Risk factors
Statistical analysis
Stroke
Thrombectomy
Thrombolysis
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Summary:Multiple randomized trials have confirmed that endovascular thrombectomy (ET) is an effective treatment method for patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). However, patients older than eighty years of age show worse functional outcomes and higher mortality rates after ET. Our retrospective study aimed to confirm the efficacy of ET in older patients and identify characteristics or variables that can be associated with a better or worse outcome of ET. The data of 102 patients with AIS aged 80 years or older were retrospectively collected from January 2019 to September 2020 from the Clinical University Hospital of Split (Department of Neurology). All patients had the AIS caused by occlusion of the M1 segment of the middle cerebral artery (MCA), 51 of them were treated with ET, and 51 of them received general supportive measures (symptomatic therapy – ST group). Detailed demographic information about age, gender, previous diseases (stroke risk factors), baseline National Institute of Health Stroke Scale (NIHSS), and modified Rankin Scale (mRS), as well as NIHSS and mRS at discharge, were collected. In addition, concomitant use of recombinant tissue-type plasminogen activator, symptom onset to hospital admission time, time from admission to groin puncture, thrombectomy duration, and thrombolysis in cerebral infarction scale (TICI) recanalization grading scores were collected. Rates of functional independence (mRS score 0–2) were significantly higher among elderly patients treated with ET than with ST (14 vs. 8% respectively, Z = 1.98, p 
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2022.107378