Efficacy of endovascular revascularization in elderly patients with acute large vessel occlusion: analysis from the RESCUE-Japan retrospective nationwide survey.
BACKGROUND
The purpose of this study was to evaluate the efficacy of endovascular treatment (EVT) in elderly patients (≥ 75 years of age) with acute large-vessel occlusion (LVO).


METHODS
A total of 229 patients with acute LVO treated by EVT in 2008 were registered from 68 medical centers in Japan. Among the total of 229 patients, 89 were elderly patients. We retrospectively investigated the treatment efficacy of EVT and patient outcome, and compared the parameters between the elderly and the nonelderly group.


RESULTS
Recanalization after EVT was equally obtained in both groups (P = .71). There was no significant difference in the favorable outcome (modified Rankin Scale [mRS] 0-2) between the elderly and nonelderly groups (30.3% vs 33.6%; P = .61), whereas poor outcome (mRS 5 and 6) was observed more in the elderly group than in the nonelderly group (48.3% vs 32.1%; P = .01). In patients with any recanalization (Thrombolysis in Myocardial Infarction grading system 1-3), the rates of favorable outcome in both groups were similar (39.7% vs 42.6%; P = .71). In contrast, in patients without recanalization, there was a significant difference in the poor outcome between the elderly and the nonelderly groups (76.2% vs 46.7%; P = .046). Symptomatic intracranial hemorrhage occurred in 6.7% in the elderly group and in 11.4% in the nonelderly group (P = .23).


CONCLUSIONS
The elderly population could achieve favorable outcomes comparable to the nonelderly population, especially when they achieve any recanalization by EVT. Elderly patients should not be excluded from recanalization therapy with EVT because of age.
Departmentof Neurosurgery at Gifu University Graduate School of Medicine, Gifu, Japan.
Yusuke
Y
Egashira
Shinichi
S
Yoshimura
Nobuyuki
N
Sakai
Naoya
N
Kuwayama
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002539:Cerebral Arterial Diseases / Q000175:diagnosis / Q000628:therapy*; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018579:Patient Selection; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult