Study 3: Mechanical Thrombectomy Safe and Effective for Elderly Stroke Patients
Endovascular treatment appears to be safe and effective in elderly adults with large-vessel occlusion stroke.
A retrospective cohort study of 219 elderly adults treated for acute ischemic stroke divided the patients into two groups based on age—62 patients were age 80 years or older and 157 patients were under age 80. Safety outcomes, such as intracranial hemorrhage (ICH) and mortality, and efficacy outcomes, such as successful reperfusion and 3-month good clinical outcome, were compared in the two groups.
In patients aged 80 and older, intravenous thrombolysis was more frequent (67.7%) and onset to reperfusion time was shorter (318.7) than in younger patients (52.8% and 282, respectively), but no between-group differences were found in terms of successful reperfusion, good clinical outcome, any or symptomatic ICH, or mortality.
A multivariable analysis found that onset National Institute of Health Stroke Scale (NIHSS) score and 24-hour clinical improvement were independent predictors of 3-month functional independence in the older group.
Paying particular attention to onset NIHSS score could speed endovascular procedures and help achieve reperfusion and good clinical outcomes. “For elderly adults showing remarkable clinical improvement in the early period after the procedure, all efforts should be made to prevent or treat post-stroke complications, which are known to strongly affect short-term, intermediate-term, and long-term morbidity and mortality,” stated the researchers.
Sallustio F, et al. Efficacy and Safety of Mechanical Thrombectomy in Older Adults With Acute Ischemic Stoke. J Am Geriatr Soc. 2017 Aug;65(8):1816-1820. doi: 10.1111/jgs.14909.