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Article: Outcomes and poor prognostic factors in endovascular thrombectomy for octo- and nonagenarians with large vessel occlusion: A real-world experience

TitleOutcomes and poor prognostic factors in endovascular thrombectomy for octo- and nonagenarians with large vessel occlusion: A real-world experience
Authors
Keywordsendovascular thrombectomy
geriatric
ischemic stroke
Issue Date2023
Citation
Surgical Practice, 2023, v. 27, n. 4, p. 232-238 How to Cite?
AbstractEndovascular thrombectomy (EVT) is the preferred treatment for eligible patients with acute large vessel occlusions (LVOs). However, its role in very elderly patients remains uncertain. This study retrospectively analysed EVT outcomes, including successful reperfusion, change in National Institutes of Health Stroke Scale (NIHSS) score at 24 h after EVT, inpatient haemorrhagic transformation and favourable functional outcomes and mortality at 90 days after EVT in patients aged over 80 years. The primary outcome of the study was risk factors significantly associated with poorer functional outcomes at 90 days after EVT. The secondary outcomes were risk factors associated with higher NIHSS scores at 24 h after EVT and higher mortality rates at 90 days after EVT. Among the 73 octo- and nonagenarians, successful reperfusion was achieved in 86.3%, and up to 35.6% maintained functional independence at 90 days. Poorer outcomes were associated with internal carotid artery occlusion; risk factors such as hypertension, diabetes mellitus and atrial fibrillation; higher admission NIHSS score; longer time between symptom onset and successful reperfusion and unsuccessful reperfusion. EVT is both safe and effective in our elderly population, with over one-third of very elderly patients achieving satisfactory functional outcomes after EVT. Therefore, age alone should not be the sole criterion for excluding very elderly LVO patients from EVT. Instead, each patient should undergo individual assessment based on their premorbid condition, clinical presentation and LVO characteristics before making a treatment decision.
Persistent Identifierhttp://hdl.handle.net/10722/336404
ISSN
2023 Impact Factor: 0.3
2023 SCImago Journal Rankings: 0.152
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYu, Stephanie Wing Yin-
dc.contributor.authorZhuang, James Tin Fong-
dc.contributor.authorChu, Yin Lun Edward-
dc.contributor.authorTeo, Kay Cheong-
dc.contributor.authorLau, Kui Kai-
dc.contributor.authorTsang, Anderson Chun On-
dc.contributor.authorLui, Wai Man-
dc.date.accessioned2024-01-15T08:26:35Z-
dc.date.available2024-01-15T08:26:35Z-
dc.date.issued2023-
dc.identifier.citationSurgical Practice, 2023, v. 27, n. 4, p. 232-238-
dc.identifier.issn1744-1625-
dc.identifier.urihttp://hdl.handle.net/10722/336404-
dc.description.abstractEndovascular thrombectomy (EVT) is the preferred treatment for eligible patients with acute large vessel occlusions (LVOs). However, its role in very elderly patients remains uncertain. This study retrospectively analysed EVT outcomes, including successful reperfusion, change in National Institutes of Health Stroke Scale (NIHSS) score at 24 h after EVT, inpatient haemorrhagic transformation and favourable functional outcomes and mortality at 90 days after EVT in patients aged over 80 years. The primary outcome of the study was risk factors significantly associated with poorer functional outcomes at 90 days after EVT. The secondary outcomes were risk factors associated with higher NIHSS scores at 24 h after EVT and higher mortality rates at 90 days after EVT. Among the 73 octo- and nonagenarians, successful reperfusion was achieved in 86.3%, and up to 35.6% maintained functional independence at 90 days. Poorer outcomes were associated with internal carotid artery occlusion; risk factors such as hypertension, diabetes mellitus and atrial fibrillation; higher admission NIHSS score; longer time between symptom onset and successful reperfusion and unsuccessful reperfusion. EVT is both safe and effective in our elderly population, with over one-third of very elderly patients achieving satisfactory functional outcomes after EVT. Therefore, age alone should not be the sole criterion for excluding very elderly LVO patients from EVT. Instead, each patient should undergo individual assessment based on their premorbid condition, clinical presentation and LVO characteristics before making a treatment decision.-
dc.languageeng-
dc.relation.ispartofSurgical Practice-
dc.subjectendovascular thrombectomy-
dc.subjectgeriatric-
dc.subjectischemic stroke-
dc.titleOutcomes and poor prognostic factors in endovascular thrombectomy for octo- and nonagenarians with large vessel occlusion: A real-world experience-
dc.typeArticle-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/1744-1633.12665-
dc.identifier.scopuseid_2-s2.0-85177656127-
dc.identifier.volume27-
dc.identifier.issue4-
dc.identifier.spage232-
dc.identifier.epage238-
dc.identifier.eissn1744-1633-
dc.identifier.isiWOS:001156827900003-

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