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RT Journal Article
SR Electronic
T1 Higher Rates of Mortality but Not Morbidity Follow Intracranial Mechanical Thrombectomy in the Elderly
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1181
OP 1185
DO 10.3174/ajnr.A2079
VO 31
IS 7
A1 Loh, Y.
A1 Kim, D.
A1 Shi, Z.-S.
A1 Tateshima, S.
A1 Vespa, P.M.
A1 Gonzalez, N.R.
A1 Starkman, S.
A1 Saver, J.L.
A1 Jahan, R.
A1 Liebeskind, D.S.
A1 Duckwiler, G.R.
A1 Viñuela, F.
YR 2010
UL http://www.ajnr.org/content/31/7/1181.abstract
AB BACKGROUND AND PURPOSE: Mechanical thrombectomy is a promising means of recanalizing acute cerebrovascular occlusions in certain situations. We sought to determine if increasing age adversely affects prognosis. MATERIALS AND METHODS: We reviewed all Merci thrombectomy cases and compared patients younger than 80 years of age with older individuals. We compared these 2 age groups with respect to recanalization rates, hospital LOS, hemorrhagic transformation, and death and disability on discharge. RESULTS: Elderly patients were more likely to die from their stroke than those younger than 80 years of age, regardless of recanalization success (48% versus 15%; OR, 5.5; 95% CI, 2.1–14.1). Among survivors, there was no difference in the probability of having a good functional outcome (mRS, ≤2) by discharge (38% versus 40%; OR, 0.9; 95% CI, 0.3–2.8). Hemorrhagic transformation did not vary between age groups. CONCLUSIONS: Among patients undergoing mechanical thrombectomy for acute cerebrovascular occlusions, increased age conveys a higher rate of stroke-related death, but disability at discharge in this group is similar to that of younger survivors. AOLarterial occlusive lesionCIconfidence intervalHThemorrhagic transformationIAintra-arterialICAinternal carotid arteryLOSlength of stayMCAmiddle cerebral arteryMERCIMechanical Embolus Removal in Cerebral IschemiamRSmodified Rankin ScaleNIHSSNational Institutes of Health Stroke ScaleORodds ratioPHparenchymal hematomaPTApercutaneous transluminal angioplastyrtPArecombinant tissue plasminogen activatorTIAtransient ischemic attack