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Safety and outcomes of different endovascular treatment techniques for anterior circulation ischaemic stroke in the elderly: data from the Imperial College Thrombectomy Registry

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Název: Safety and outcomes of different endovascular treatment techniques for anterior circulation ischaemic stroke in the elderly: data from the Imperial College Thrombectomy Registry
Autoři: D'Anna, Lucio, Barba, Lorenzo, Foschi, Matteo, Romoli, Michele, Abu-Rumeileh, Samir, Dolkar, Tsering, Vittay, Orsolya, Dixon, Luke, Bentley, Paul, Brown, Zoe, Hall, Charles, Halse, Omid, Jamil, Sohaa, Jenkins, Harri, Kalladka, Dheeraj, Kwan, Joseph, Malik, Abid, Patel, Maneesh, Rane, Neil, Roi, Dylan, Singh, Abhinav, Venter, Marius, Banerjee, Soma, Lobotesis, Kyriakos
Zdroj: J Neurol
Informace o vydavateli: Springer Science and Business Media LLC, 2023.
Rok vydání: 2023
Témata: Adult, Original Communication, Endovascular Procedures, Elderly, Ischemic stroke, Mechanical thrombectomy, Technique, Brain Ischemia/surgery [MeSH], Ischemic Stroke/epidemiology [MeSH], Ischemic Stroke/surgery [MeSH], Aged [MeSH], Thrombectomy/methods [MeSH], Adult [MeSH], Humans [MeSH], Prospective Studies [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Brain Ischemia/complications [MeSH], Stroke/surgery [MeSH], Stroke/epidemiology [MeSH], Endovascular Procedures/adverse effects [MeSH], Thrombectomy/adverse effects [MeSH], Registries [MeSH], 3. Good health, Brain Ischemia, Stroke, Treatment Outcome, Humans, Prospective Studies, Registries, Aged, Retrospective Studies, Thrombectomy, Ischemic Stroke
Popis: Background Although previous studies investigated the main predictors of outcomes after endovascular thrombectomy (EVT) in patients aged 80 years and older, less is known about the impact of the procedural features on outcomes in elderly patients. The aim of this study was to investigate the influence of EVT technical procedures on the main 3-month outcomes in a population of patients aged 80 years and older. Methods This observational, prospective, single-centre study included consecutive patients with acute LVO ischaemic stroke of the anterior circulation. The study outcomes were functional independence at 3 months after EVT (defined as a mRS score of 0–2), successful reperfusion (mTICI ≥ 2b), incidence of haeamorrhagic transformation, and 90-day all cause of mortality. Results Our cohort included 497 patients with acute ischaemic stroke due to LVO treated with EVT. Among them, 105 (21.1%) patients were aged ≥ 80 years. In the elderly group, multivariable regression analysis showed that thromboaspiration technique vs stent-retriever was the single independent predictor of favourable post-procedural TICI score (OR = 7.65, 95%CI = 2.22–26.32, p = 0.001). Conclusions Our study suggests that EVT for LVO stroke in the elderly could be safe. The use of thromboaspiration was associated with positive reperfusion outcome in this population. Further studies in larger series are warranted to confirm the present results and to evaluate the safety and efficacy of EVT in the elderly and oldest adults.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1432-1459
0340-5354
DOI: 10.1007/s00415-023-12077-3
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37982851
https://repository.publisso.de/resource/frl:6497254
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....82039a496684fce64b74d20a1ae361c0
Databáze: OpenAIRE
Popis
Abstrakt:Background Although previous studies investigated the main predictors of outcomes after endovascular thrombectomy (EVT) in patients aged 80 years and older, less is known about the impact of the procedural features on outcomes in elderly patients. The aim of this study was to investigate the influence of EVT technical procedures on the main 3-month outcomes in a population of patients aged 80 years and older. Methods This observational, prospective, single-centre study included consecutive patients with acute LVO ischaemic stroke of the anterior circulation. The study outcomes were functional independence at 3 months after EVT (defined as a mRS score of 0–2), successful reperfusion (mTICI ≥ 2b), incidence of haeamorrhagic transformation, and 90-day all cause of mortality. Results Our cohort included 497 patients with acute ischaemic stroke due to LVO treated with EVT. Among them, 105 (21.1%) patients were aged ≥ 80 years. In the elderly group, multivariable regression analysis showed that thromboaspiration technique vs stent-retriever was the single independent predictor of favourable post-procedural TICI score (OR = 7.65, 95%CI = 2.22–26.32, p = 0.001). Conclusions Our study suggests that EVT for LVO stroke in the elderly could be safe. The use of thromboaspiration was associated with positive reperfusion outcome in this population. Further studies in larger series are warranted to confirm the present results and to evaluate the safety and efficacy of EVT in the elderly and oldest adults.
ISSN:14321459
03405354
DOI:10.1007/s00415-023-12077-3