title: Safe and effective outcome of intravenous thrombolysis for acute ischemic stroke in patients aged 90 years or older.
abstract: Concerning intravenous thrombolysis, only inconclusive data are available for patients older than 90. We retrospectively evaluated 11 such patients whom we treated with thrombolysis from June 2007 through April 2012, comparing them to 41 patients of the same age whom we treated conventionally in the same period. Baseline clinical data were superimposable, except for shorter onset-to-hospital time for thrombolyzed patients. Mortality and hemorrhagic transformation did not differ. Functional status (modified Rankin scale) 3 months after was better in treated patients, even when compared to controls who arrived early in the hospital. Treated patients were more often discharged home or to intensive rehabilitation, less often to a nursing home. We conclude that safety and effectiveness of intravenous thrombolysis in eligible nonagenarians are evident in a setting of everyday practice, and that patients 90 years or older should not be denied thrombolysis solely on the basis of their age.
authors.affiliation: Department of Neuroscience, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy. mbalestrino @ neurologia.unige.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Balestrino
authors.forename: Valeria
authors.initials: V
authors.lastname: Carlino
authors.forename: Chiara
authors.initials: C
authors.lastname: Bruno
authors.forename: Cinzia
authors.initials: C
authors.lastname: Finocchi
authors.forename: Giovanni Luigi
authors.initials: GL
authors.lastname: Mancardi
authors.forename: Massimo
authors.initials: M
authors.lastname: Del Sette
authors.forename: Carlo
authors.initials: C
authors.lastname: Gandolfo
mesh_terms: D061605:Administration, Intravenous; D000369:Aged, 80 and over; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator