Mechanical thrombectomy for ischemic anterior circulation stroke patients older than 80 years. A single center experience.

Congress:

ECR 2019

Poster Number:

C-1105

Type:

Scientific Exhibit

Keywords:

Acute, Thrombolysis, Recanalisation, Catheter arteriography, Vascular, Neuroradiology brain, Interventional vascular, Embolism / Thrombosis

Authors:

I. Oronoz Mitxelena¹, O. Chirife¹, R. Barranco Pons¹, L. Aja Rodríguez¹, M. A. De Miquel¹, S. Aixut Lorenzo¹, B. Lara¹, H. Quesada García², P. Cardona¹; ¹Barcelona/ES, ²L´Hospitalet de Llobregat (Barcelona) /ES

DOI:

10.26044/ecr2019/C-1105

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1105

Fig. 2: Distribution plot of ASPECTS and of baseline functional status (NIHSS).

Fig. 3: Distribution plot of recanalization (mTICI).

Fig. 4: Scores on the modified Rankin Scale at 90 days. Distribution of scores at 90...

Fig. 5: Distribution plot of hemorrhagic transformation.

Aims and objectives

Mechanical thrombectomy as a revascularization method has proven to be an effective treatment for acute ischemic stroke secundary to large vessel occlusion. However there is limited and ambiguous information about the functional outcome in the specific group of elderly patients (> 80 years) undergoing this treatment. In this study we wanted to investigate the efficacy and safety of mechanical thrombectomy in patients with acute ischemic anterior circulation stroke in elderly patients older than 80 years.

Methods and materials

In this single-center retrospective study every patient with acute ischemic stroke of anterior circulation, older than 80 years old, undergoing mechanical thrombectomy between January 2015 and December 2017 was included. They were a total of 60 patients. We assessed demographic and clinical variables such as sex, age, cardiovascular risk factors (diabetes mellitus -DM-, hypertension) or atrial fibrilation (AFib). Acute neurological status was assessed using the National Institutes of Health Stroke Scale (NIHSS), functional status using the modified Rankin Scale (mRS) (for assessment of baseline functional...

Results

The average age was 84.4 years (range 81-94). Fig. 1. 31.7% were men and 68.3% were women. All patients had a baseline mRs ≤ 2. The median of the ASPECTS was 9, with an average of NIHSS of 19. Fig. 2. Successful recanalization (mTICI 2b-3) was achieved in 81.7% of cases. Fig. 3 . 35.6% of the patients achieved functional independence (mRS ≤ 2) at 3 months, and 17% a mild dependence (mRS 3). The 3-month mortality rate was 18,6%, and the rate of clinically...

Conclusion

In our experience, treatment with mechanical thrombectomy in elderly patients older than 80 years, with restrictive criteria, is a safe and effective method that achieves functional independence in more than a third of cases.

Personal information

References

M. Goyal, B. K. Menon, W.H van Zwam, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials. Lancet 2016; 387: 1723-31. T.G. Jovin, A. Chamorro, E. Cobo, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke. N Engl J Med 2015; 372: 2296-306. P. Cardona,B. Lara,H. Quesada, et al. Endovascular treatment in elderly patient. Should we continue treating them? Stroke. 2017; 48: AWP27. W. Hacke, M. Kaste, C. Fieschi, et al. Randomised double-blind...