title: Intra-arterial thrombolysis for acute ischemic stroke in octogenarians.
abstract: BACKGROUND
  It is unclear whether octogenarians benefit from intra-arterial thrombolysis (IAT) for the treatment of acute ischemic stroke (AIS). The aim of the present study was to compare baseline characteristics, clinical outcome and complications of patients aged ≥80 with those of patients aged <80 years.
  
  
  METHODS
  Forty-three octogenarians and 524 younger patients with AIS were treated with IAT. The modified Rankin scale (mRS) score was used to assess 3-month outcome.
  
  
  RESULTS
  There was a female preponderance among octogenarians (63 vs. 37%, p = 0.015). Stroke severity, occlusion site, and time from stroke onset to IAT did not differ between the groups. Good recanalization (TIMI 2-3) was achieved in 65% of older and in 71% of younger patients (p = 0.449). Rates of symptomatic intracranial hemorrhage (ICH) were 6% in patients <80 years and 2% in octogenarians (p = 0.292). Favorable outcome (mRS 0-2) was less frequent among octogenarians (28 vs. 46%, p = 0.019), while mortality was higher (40 vs. 22%, p = 0.008). Octogenarians died more often from extracerebral complications than younger patients (59 vs. 27%, p = 0.008).
  
  
  CONCLUSIONS
  Compared with younger patients, octogenarians did not have a significantly increased risk of symptomatic ICH after IAT. Although favorable outcome was less frequent and mortality rates were higher, IAT appeared to be safe in octogenarians. It seems reasonable to include octogenarians in randomized clinical trials to assess the balance of risk and benefit of IAT in this patient group.
authors.affiliation: Department of Neurology, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Mono
authors.forename: Lorenz
authors.initials: L
authors.lastname: Romagna
authors.forename: Simon
authors.initials: S
authors.lastname: Jung
authors.forename: Marcel
authors.initials: M
authors.lastname: Arnold
authors.forename: Aekaterini
authors.initials: A
authors.lastname: Galimanis
authors.forename: Urs
authors.initials: U
authors.lastname: Fischer
authors.forename: Adrian
authors.initials: A
authors.lastname: Kohler
authors.forename: Pietro
authors.initials: P
authors.lastname: Ballinari
authors.forename: Caspar
authors.initials: C
authors.lastname: Brekenfeld
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.forename: Heinrich P
authors.initials: HP
authors.lastname: Mattle
authors.forename: Krassen
authors.initials: K
authors.lastname: Nedeltchev
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy* / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007261:Infusions, Intra-Arterial; D020300:Intracranial Hemorrhages / Q000139:chemically induced; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality; D013557:Switzerland; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents