학술논문
Endovascular Treatment of Very Elderly Patients Aged ≥90 With Acute Ischemic Stroke
Document Type
article
Author
Lukas Meyer; Maria Alexandrou; Fabian Flottmann; Milani Deb‐Chatterji; Nuran Abdullayev; Volker Maus; Maria Politi; Kathleen Bernkopf; Christian Roth; Andreas Kastrup; Uta Hanning; Caspar Brekenfeld; Götz Thomalla; Christian Gerloff; Anastasios Mpotsaris; Panagiotis Papanagiotou; Jens Fiehler; Hannes Leischner
Source
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 9, Iss 5 (2020)
Subject
Language
English
ISSN
2047-9980
Abstract
Background Patients aged ≥90 were excluded or under‐represented in past thrombectomy trials; thus, uncertainty remains whether treatment benefits can be expected regardless of age. This study investigates outcome and safety of thrombectomy in nonagenarians to improve decision making in a real‐world setting. Methods and Results All currently available data of patients aged ≥90 enrolled in the GSR‐ET (German Stroke Registry–Endovascular Treatment) were combined with a smaller cohort from 3 tertiary stroke centers. Baseline characteristics, procedural (Thrombolysis in Cerebral Infarction scale) and functional outcomes (modified Rankin Scale; mRS), as well as complications (symptomatic intracranial hemorrhage, serious adverse events; SAEs) were analyzed. Good functional outcome was defined as mRS ≤3 at 90‐days. 203 patients with anterior circulation stroke and prestroke mRS ≤3 were included. The rate of successful recanalization (Thrombolysis in Cerebral Infarction scale ≥2b) was 75.9% (154/203). Good functional outcome (mRS ≤3) was observed in 21.6% (41 of 193) at 90‐days. In‐hospital mortality was 27.1% (55 of 203) and increased significantly at 90 days to 48.9% (93 of 190; P