title: Age ≥80 Years Is Not a Contraindication for Intra-Arterial Therapy after Ischemic Stroke.
abstract: BACKGROUND
  Clinical trials confirmed the safety and efficacy of intra-arterial therapy (IAT) in the management of ischemic stroke. At a community hospital, we compared outcomes in patients aged ≥80 and patients in the age range 55-79 years receiving IAT following ischemic stroke.
  
  
  METHODS
  Data were retrospectively abstracted for ischemic stroke patients ≥55 years treated with IAT at an urban comprehensive stroke center between 2010 and 2013. Baseline demographics, incidence of symptomatic intracranial hemorrhage (sICH), in-hospital mortality, discharge modified Rankin scale (mRS) score (favorable ≤2) and improvement in National Institutes of Health Stroke Scale Score (NIHSS; decreased score at discharge) were compared between patients in the age range 55-79 and patients ≥80 years. Data were analyzed using univariate analyses and multivariate logistic regression.
  
  
  RESULTS
  IAT was performed in 239 patients with ischemic stroke; 63 (26.4%) were ≥80 years. When compared to patients aged 55-79, the elderly patients were more often female and non-smokers, with a history of atrial fibrillation. No differences were observed in those ≥80 years compared to patients in the age range 55-79 years for sICH (10 vs. 5%, p = 0.23), mortality (24 vs. 18%, p = 0.28), favorable discharge mRS score (13 vs. 19%, p = 0.27), or improvement in NIHSS (83 vs. 92%, p = 0.10). The nonsignificant association of age with the outcomes persisted after adjusting for covariates and when analyzing the subset of patients who received IAT only.
  
  
  CONCLUSIONS
  These findings suggest that in a cohort not subject to the criteria of a clinical trial, age ≥80 years should not be a contraindication to IAT.
authors.affiliation: Department of Trauma Research, Swedish Medical Center, Englewood, Colo., USA.
authors.forename: Jan
authors.initials: J
authors.lastname: Leonard
authors.forename: Donald
authors.initials: D
authors.lastname: Frei
authors.forename: Kristin
authors.initials: K
authors.lastname: Salottolo
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Fanale
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Wagner
authors.forename: Michelle
authors.initials: M
authors.lastname: Whaley
authors.forename: Kathryn
authors.initials: K
authors.lastname: McCarthy
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bellon
authors.forename: David
authors.initials: D
authors.lastname: Loy
authors.forename: David
authors.initials: D
authors.lastname: Bar-Or
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D002986:Clinical Trials as Topic; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator