Efficacy, safety, and clinical outcome of modern mechanical thrombectomy in elderly patients with acute ischemic stroke

被引：63

作者：

Son, Seungnam ^{[1
]}

Kang, Dong-Hun ^{[2
,3
,4
]}

Hwang, Yang-Ha ^{[4
,5
]}

Kim, Yong-Sun ^{[3
,4
]}

Kim, Yong-Won ^{[3
,4
,5
]}

机构：

[1] Jinju Hanil Hosp, Dept Neurol, Jinju, South Korea

[2] Kyungpook Natl Univ Hosp, Dept Neurosurg, Daegu, South Korea

[3] Kyungpook Natl Univ Hosp, Dept Radiol, Daegu, South Korea

[4] Kyungpook Natl Univ, Sch Med, 130 Dongduk Ro, Daegu 41944, South Korea

[5] Kyungpook Natl Univ Hosp, Dept Neurol, Daegu, South Korea

来源：

ACTA NEUROCHIRURGICA | 2017年 / 159卷 / 09期

关键词：

Acute ischemic stroke; Elderly patients; Mechanical thrombectomy; Stent retriever; Aspiration thrombectomy; STENT-RETRIEVER THROMBECTOMY; ENDOVASCULAR TREATMENT; POOLED ANALYSIS; RECANALIZATION; MORTALITY; REVASCULARIZATION; METAANALYSIS; VESSEL; IMPACT; DEVICE;

D O I：

10.1007/s00701-017-3269-y

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

The average life expectancy is increasing worldwide, surpassing 80 years in some countries. Recently, mechanical thrombectomy (MT) using modern devices and techniques has led to improved clinical outcomes following acute ischemic stroke. However, thus far, it remains uncertain whether MT is effective in elderly patients aged over 80 years. Between July 2013 and June 2016, 207 patients with acute ischemic stroke in the anterior circulation received MT at our center. The applied MT strategies were forced arterial suction thrombectomy (FAST) and stent retriever thrombectomy. Patients were divided into those < 80 years (n = 173) and those ae<yen>80 years (n = 34). We compared clinical and angiographic parameters between groups. The median age was 67.5 in the younger group and 82 in the elderly group; 92.5% of the younger group and 70.6% of the elderly group received MT via the FAST technique. Angiographic outcomes, including procedural time, mTICI 2b-3 reperfusion (85.5% vs. 82.4%, p = 0.633), and symptomatic intracranial hemorrhage, were not different between the groups. A favorable clinical outcome rate was significantly higher in the younger group (62.4% vs. 44.1%, p = 0.047). Younger age, a low NIHSS score, and fast onset to reperfusion time were favorable prognostic factors in elderly patients. Modern MT in elderly patients with acute ischemic stroke is safe and effective compared to younger patients despite a lower favorable clinical outcome. Our findings may suggest that an appropriate MT strategy with respect to the location of the target occlusion and vascular tortuosity might be helpful to achieve fast reperfusion and improved outcomes for elderly patients.

引用

页码：1663 / 1669

页数：7

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