title: Recanalization and mortality rates of thrombectomy with stent-retrievers in octogenarian patients with acute ischemic stroke.
abstract: BACKGROUND
  Our objective was to evaluate the effect of treatment with stent-retrievers in octogenarians suffering an acute ischemic stroke.
  
  
  METHODS
  A total of 150 consecutive patients with acute stroke who were treated with stent-retrievers between April 2010 and June 2012 were retrospectively reviewed. Patients were divided into those <80 years old (n = 116) and those ≥80 (n = 34). Baseline characteristics, procedure data, and endpoints (postprocedural NIHSS, death, and mRS at 3 months) were compared.
  
  
  RESULTS
  High blood pressure, atrial fibrillation, and anticoagulation were more frequent in octogenarians (p = 0.01, 0.003, and 0.04 respectively). There were no differences between both groups regarding previous intravenous thrombolysis (32.4 vs. 48.3 %, p = 0.1), preprocedural NIHSS (18.1 vs. 16.8, p = 0.3), procedure time (74.5 (40-114) min vs. 63 (38-92) min, p = 0.2), revascularization time (380.5 (298-526.3) min vs. 350 (296.3-452.8), p = 0.3), TICI ≥ 2B (88.2 vs. 93.9 %, p = 0.1), and symptomatic haemorrhage (5.9 vs. 2.6 %, p = 0.3). Discharge NIHSS was higher in octogenarians (9.7 vs. 6.5, p = 0.03). Death and 3-month mRS ≥3 were more frequent in octogenarians (35.3 vs. 17.2 %, p = 0.02 and 73.5 vs. 37.1 %, p = 0.02). ICA-involvement and prolonged revascularization involved higher mortality (66.7 vs. 27.6 %, p = 0.03) and worse mRS (50 vs. 24.4 %, p = 0.06) in octogenarians.
  
  
  CONCLUSIONS
  In our series, treatment with stent-retrievers in octogenarians with acute ischemic stroke achieved good rates of recanalization but with a high mortality rate. ICA involvement and revascularization times beyond 6 hours associated to a worse prognosis. These data might be of value in the design of prospective studies evaluating the clinical efficacy of the endovascular treatments in octogenarians.
authors.affiliation: Service of Interventional Neuroradiology, Hospital Clínico Universitario Virgen de la Arrixaca, Carretera Madrid-Cartagena S/N, 30120, Murcia, Spain, gpr1972@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Parrilla
authors.forename: E
authors.initials: E
authors.lastname: Carreón
authors.forename: J
authors.initials: J
authors.lastname: Zamarro
authors.forename: M
authors.initials: M
authors.lastname: Espinosa de Rueda
authors.forename: B
authors.initials: B
authors.lastname: García-Villalba
authors.forename: F
authors.initials: F
authors.lastname: Marín
authors.forename: F
authors.initials: F
authors.lastname: Hernández-Fernández
authors.forename: A
authors.initials: A
authors.lastname: Morales
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Vivas
authors.forename: R
authors.initials: R
authors.lastname: Núñez
authors.forename: A
authors.initials: A
authors.lastname: Moreno
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents; D020521:Stroke / Q000453:epidemiology* / Q000601:surgery*; D017131:Thrombectomy / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome