Abstract 3311: Acute stroke and endovascular outcomes in Elderly Population: A Single Center Experience.
Background: In the setting of acute ischemic stroke, endovascular intervention, once considered experimental, is now gold standard of care of appropriately selected patients. Among the elderly, aged 80 and above, patients have multiple comorbidities, and little data exists regarding clinical outcome for those undergoing different endovascular treatment modalities.
Objectives: To assess the safety and efficacy of different endovascular treatment modalities in elderly, aged 80 and above, compared to patients younger than 80 with acute ischemic stroke
Methods: Restrospective chart review was performed in 150 consecutive patients who underwent endovascular treatments for acute ischemic stroke at our center between 2008 and 2011, between age range 17 -93 years. Elderly patients (EP) age 80 and above (n=34) were compared to nonelderly patients age <80 (NEP) (n=116). The patients in both groups underwent mechanical (including MERCI and or Penumbra and/or angioplasty and stenting) and/or chemical thrombolysis (intra-arterial tPA). We compared the specific outcome parameters of EP vs NEP groups, including discharge NIHSS, modified Rankin Scale (mRS), rate of partial to complete recanalization (TIMI 2-3), symptomatic intracerebral hemorrhage (ICH), and all cause mortality.
Results: In EP, mean age was 84.9 ± 3.3, with 32.3% (n=11) males and 67.6% (n=23) females. In NEP mean age was 63.6 ± 13.1, with 50.9% (n=59) males and 49.1% (n=57) females. 91.3% (n=106) In EP vs NEP, mean initial NIHSS were 19±7 and 16±6, and discharge NIHSS 9±7 and 12±8, respectively. Rates of recanalization occurred in 67.6% (n=23) in EP, and 71.6% (n=83) in NEP. Discharge mRS 3 or less was 2.9% (n=1) in EP, and 17.2% (n=20) in NEP. Symptomatic ICH occurred in 20.6% (n=7) in EP and 14.7% (n=17) in NEP. All cause mortality rate at discharge in EP group was 41.2% (n=14) and 19.8% (n=23) in NEP.
Conclusions: In our experience EP had poor clinical outcomes with increased mortality and hemorrhage rate compared to NEP irrespective of similar recanalization rate. Further prospective trial is warranted to evaluate safety and efficacy of endovascular treatment in patients aged 80 years old and above.
- © 2012 by American Heart Association, Inc.