Influence of Age on Clinical and Revascularization Outcomes in the North American Solitaire Stent-Retriever Acute Stroke Registry

被引：89

作者：

Castonguay, Alicia C. ^{[1
]}

Zaidat, Osama O. ^{[1
,2
,3
,4
]}

Novakovic, Roberta ^{[5
,6
]}

Nguyen, Thanh N. ^{[7
,8
,9
]}

Taqi, M. Asif ^{[10
]}

Gupta, Rishi ^{[11
]}

Sun, Chung-Huan J. ^{[12
]}

Martin, Coleman ^{[13
]}

Holloway, William E. ^{[13
]}

Mueller-Kronast, Nils ^{[14
]}

English, Joey E. ^{[15
]}

Linfante, Italo ^{[16
]}

Dabus, Guilherme ^{[16
]}

Malisch, Tim W. ^{[17
]}

Marden, Franklin A. ^{[17
]}

Bozorgchami, Hormozd ^{[18
]}

Xavier, Andrew ^{[19
]}

Rai, Ansaar T. ^{[20
]}

Froehler, Michael T. ^{[21
,22
,23
]}

Badruddin, Aamir ^{[24
]}

Abraham, Michael G. ^{[25
]}

Janardhan, Vallabh ^{[26
]}

Shaltoni, Hashem ^{[27
]}

Yoo, Albert J. ^{[28
]}

Abou-Chebl, Alex ^{[26
]}

Chen, Peng R. ^{[29
]}

Britz, Gavin W. ^{[30
]}

Kaushal, Ritesh ^{[31
]}

Nanda, Ashish ^{[32
]}

Issa, Mohammad A. ^{[1
]}

Nogueira, Raul G. ^{[12
]}

机构：

[1] Med Coll Wisconsin, Dept Neurol, Froedtert Hosp, Milwaukee, WI 53226 USA

[2] Med Coll Wisconsin, Dept Neurosurg, Froedtert Hosp, Milwaukee, WI 53226 USA

[3] Med Coll Wisconsin, Dept Radiol, Froedtert Hosp, Milwaukee, WI 53226 USA

[4] Med Coll Wisconsin, Dept Radiol, Froedtert Hosp, Milwaukee, WI 53226 USA

[5] UT Suthwestern Med Ctr, Dept Radiol, Dallas, TX USA

[6] UT Suthwestern Med Ctr, Dept Neurol, Dallas, TX USA

[7] Boston Med Ctr, Dept Neurol, Boston, MA USA

[8] Boston Med Ctr, Dept Neurosurg, Boston, MA USA

[9] Boston Med Ctr, Dept Radiol, Boston, MA USA

[10] Desert Reg Med Ctr, Palm Springs, CA USA

[11] Wellstar Neurosurg Kennestone Hosp, Atlanta, GA USA

[12] Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA

[13] St Lukes Kansas City, Kansas City, MO USA

[14] Delray Med Ctr, Dept Neurol, Delray Beach, FL USA

[15] Calif Pacific Med Ctr, San Francisco, CA USA

[16] Baptist Cardiac & Vasc Inst, Div Intervent Neuroradiol, Miami, FL USA

[17] Alexian Bros Med Ctr, Elk Grove Village, IL USA

[18] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[19] Wayne State Univ, Sch Med, Dept Neurol, Detroit, MI 48201 USA

[20] West Virginia Univ Hosp, Dept Radiol, Morgantown, WV USA

[21] Vanderbilt Univ, Med Ctr, Dept Neurol, Nashville, TN USA

[22] Vanderbilt Univ, Med Ctr, Dept Neurosurg, Nashville, TN USA

[23] Vanderbilt Univ, Med Ctr, Dept Radiol, Nashville, TN USA

[24] Provena St Joseph Med Ctr, Joliet, IL USA

[25] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA

[26] Texas Stroke Inst, Plano, TX USA

[27] Univ Texas Hlth Sci Ctr Houston, Houston, TX 77030 USA

[28] Massachusetts Gen Hosp, Dept Radiol, Div Diagnost & Intervent Neuroradiol, Boston, MA 02114 USA

[29] Univ Texas Houston, Houston, TX USA

[30] Methodist Neurol Inst, Dept Neurosurg, Houston, TX USA

[31] St Louis Univ, St Louis, MO 63103 USA

[32] Univ Missouri, Columbia, MO USA

来源：

STROKE | 2014年 / 45卷 / 12期

基金：

美国国家卫生研究院;

关键词：

age groups; aged; stroke; thrombectomy; ACUTE ISCHEMIC-STROKE; INFARCT VOLUME; INTRAARTERIAL THROMBOLYSIS; MECHANICAL THROMBECTOMY; RECANALIZATION; MORTALITY; OCCLUSION; THERAPY; DEVICE; OLDER;

D O I：

10.1161/STROKEAHA.114.006487

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-The Solitaire With the Intention for Thrombectomy (SWIFT) and thrombectomy revascularization of large vessel occlusions in acute ischemic stroke (TREVO 2) trial results demonstrated improved recanalization rates with mechanical thrombectomy; however, outcomes in the elderly population remain poorly understood. Here, we report the effect of age on clinical and angiographic outcome within the North American Solitaire-FR Stent-Retriever Acute Stroke (NASA) Registry. Methods-The NASA Registry recruited sites to submit data on consecutive patients treated with Solitaire-FR. Influence of age on clinical and angiographic outcomes was assessed by dichotomizing the cohort into <= 80 and >80 years of age. Results-Three hundred fifty-four patients underwent treatment in 24 centers; 276 patients were <= 80 years and 78 were >80 years of age. Mean age in the <= 80 and >80 cohorts was 62.2 +/- 13.2 and 85.2 +/- 3.8 years, respectively. Of patients >80 years, 27.3% had a 90-day modified Rankin Score <= 2 versus 45.4% <= 80 years (P=0.02). Mortality was 43.9% and 27.3% in the >80 and <= 80 years cohorts, respectively (P=0.01). There was no significant difference in time to revascularization, revascularization success, or symptomatic intracranial hemorrhage between the groups. Multivariate analysis showed age >80 years as an independent predictor of poor clinical outcome and mortality. Within the >80 cohort, National Institutes of Health Stroke Scale (NIHSS), revascularization rate, rescue therapy use, and symptomatic intracranial hemorrhage were independent predictors of mortality. Conclusion-Greater than 80 years of age is predictive of poor clinical outcome and increased mortality compared with younger patients in the NASA registry. However, intravenous tissue-type plasminogen activator use, lower NIHSS, and shorter revascularization time are associated with better outcomes. Further studies are needed to understand the endovascular therapy role in this cohort compared with medical therapy.

引用

页码：3631 / +

页数：9

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