title: Interventional stroke therapies in the elderly: are we helping?
abstract: OBJECTIVE
  It is unclear whether endovascular therapies for the treatment of AIS are being offered or are safe in older adults. The use and safety of endovascular interventions in patients older than 75 years of age were assessed.
  
  
  METHODS
  A retrospective review of patients with AIS 75 years or older (n = 37/1064) was compared with a younger cohort (n = 70/1190) by using an established data base. Admission and discharge NIHSS scores, rates of endovascular treatment, SICH, in-hospital mortality, and the mBI were assessed.
  
  
  RESULTS
  Rates of endovascular treatments were significantly lower in older patients (5.9% in the younger-than-75-year versus 3.5% in the older-than-75-year cohort, P = .007). Stroke severity as measured by the NIHSS score was equivalent in the 2 age groups. The mBI at 12 months was worse in the older patients (mild or no disability in 52% of the younger-than-75-year and 22% in the 75-year-or-older cohort, P = .006). Older patients had higher rates of SICH (9% in younger-than-75-year versus 24% in the 75-year-or-older group, P = .04) and in-hospital mortality (26% in younger-than-75-year versus 46% in the 75-year-or-older group, P = .05).
  
  
  CONCLUSIONS
  Patients older than 75 years of age were less likely to receive endovascular treatments. Older patients had higher rates of SICH, disability, and mortality. Prospective randomized trials are needed to determine the criteria for selecting patients most likely to benefit from acute endovascular therapies.
authors: The Stroke Center at Hartford Hospital, Hartford, Connecticut 06102, USA.
authors: N
authors: N
authors: Zeevi
authors: G A
authors: GA
authors: Kuchel
authors: N S
authors: NS
authors: Lee
authors: I
authors: I
authors: Staff
authors: L D
authors: LD
authors: McCullough
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D003237:Connecticut / Q000453:epidemiology; D057510:Endovascular Procedures / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000401:mortality* / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome