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CardioVascular and Interventional Radiology

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01-04-2015 | Clinical Investigation

Recanalization and Mortality Rates of Thrombectomy With Stent-Retrievers in Octogenarian Patients with Acute Ischemic Stroke

Authors: G. Parrilla, E. Carreón, J. Zamarro, M. Espinosa de Rueda, B. García-Villalba, F. Marín, F. Hernández-Fernández, A. Morales, M. Fernández-Vivas, R. Núñez, A. Moreno

Published in: CardioVascular and Interventional Radiology | Issue 2/2015

Abstract

Background

Our objective was to evaluate the effect of treatment with stent-retrievers in octogenarians suffering an acute ischemic stroke.

Methods

A total of 150 consecutive patients with acute stroke who were treated with stent-retrievers between April 2010 and June 2012 were retrospectively reviewed. Patients were divided into those <80 years old (n = 116) and those ≥80 (n = 34). Baseline characteristics, procedure data, and endpoints (postprocedural NIHSS, death, and mRS at 3 months) were compared.

Results

High blood pressure, atrial fibrillation, and anticoagulation were more frequent in octogenarians (p = 0.01, 0.003, and 0.04 respectively). There were no differences between both groups regarding previous intravenous thrombolysis (32.4 vs. 48.3 %, p = 0.1), preprocedural NIHSS (18.1 vs. 16.8, p = 0.3), procedure time (74.5 (40–114) min vs. 63 (38–92) min, p = 0.2), revascularization time (380.5 (298–526.3) min vs. 350 (296.3–452.8), p = 0.3), TICI ≥ 2B (88.2 vs. 93.9 %, p = 0.1), and symptomatic haemorrhage (5.9 vs. 2.6 %, p = 0.3). Discharge NIHSS was higher in octogenarians (9.7 vs. 6.5, p = 0.03). Death and 3-month mRS ≥3 were more frequent in octogenarians (35.3 vs. 17.2 %, p = 0.02 and 73.5 vs. 37.1 %, p = 0.02). ICA-involvement and prolonged revascularization involved higher mortality (66.7 vs. 27.6 %, p = 0.03) and worse mRS (50 vs. 24.4 %, p = 0.06) in octogenarians.

Conclusions

In our series, treatment with stent-retrievers in octogenarians with acute ischemic stroke achieved good rates of recanalization but with a high mortality rate. ICA involvement and revascularization times beyond 6 hours associated to a worse prognosis. These data might be of value in the design of prospective studies evaluating the clinical efficacy of the endovascular treatments in octogenarians.

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Title: Recanalization and Mortality Rates of Thrombectomy With Stent-Retrievers in Octogenarian Patients with Acute Ischemic Stroke
Authors: G. Parrilla
E. Carreón
J. Zamarro
M. Espinosa de Rueda
B. García-Villalba
F. Marín
F. Hernández-Fernández
A. Morales
M. Fernández-Vivas
R. Núñez
A. Moreno
Publication date: 01-04-2015
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 2/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-014-0920-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Recanalization and Mortality Rates of Thrombectomy With Stent-Retrievers in Octogenarian Patients with Acute Ischemic Stroke

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

Methods

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