Higher rates of mortality but not morbidity follow intracranial mechanical thrombectomy in the elderly.
OBJECTIVE
Mechanical thrombectomy is a promising means of recanalizing acute cerebrovascular occlusions in certain situations. We sought to determine if increasing age adversely affects prognosis.


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, <or=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.
Loh
Yince
Y
Division of Neurosurgery, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA. yincer@yahoo.com
Kim
D
D
Shi
Z-S
ZS
Tateshima
S
S
Vespa
P M
PM
Gonzalez
N R
NR
Starkman
S
S
Saver
J L
JL
Jahan
R
R
Liebeskind
D S
DS
Duckwiler
G R
GR
Viñuela
F
F
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000401:mortality* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011379:Prognosis; D020521:Stroke / Q000401:mortality / Q000601:surgery; D017131:Thrombectomy / Q000401:mortality*; D055815:Young Adult
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