title: Endovascular mechanical recanalization of acute ischaemic stroke in octogenarians.
abstract: BACKGROUND
  Multiple studies have shown a clinical benefit of thrombectomy in acute ischaemic stroke, but most of them excluded octogenarians. The purpose of this study was to compare the outcomes between octogenarians and younger patients after thrombectomy.
  
  
  METHODS
  One hundred and sixty-six patients with large cerebral artery occlusion and consecutive thrombectomy were evaluated and divided into two patient age groups: younger than 80 years and older than 80 years. We compared recanalization rates, complications experienced, disability, death after discharge and at a 90-day follow-up between these age groups.
  
  
  RESULTS
  Sixty-eight percent of octogenarians and 72 % of younger patients were registered with successful recanalization (p = 1.0). There was no significant difference in symptomatic intracerebral haemorrhage between the groups (p = 0.32). However, octogenarians had a significantly lower rate of good clinical outcome (24 % vs. 48 %; p = 0.008) and a higher mortality rate (36 % vs. 12 %; p = 0.0013).
  
  
  CONCLUSIONS
  Octogenarians have a lower chance of good clinical outcome and a higher mortality rate despite successful recanalization. Nevertheless, 24 % of octogenarians were documented with mRS ≤2. As this age group of octogenarians will grow prospectively, careful patient selection should be mandatory when considering octogenarians for thrombectomy.
  
  
  CONCLUSIONS
  • Careful patient selection for thrombectomy should be mandatory in octogenarians. • Octogenarians have a higher mortality rate despite successful recanalization. • Nearly one-third of octogenarians were documented with a good clinical outcome.
authors.affiliation: Department of Neuroradiology, Paracelsus Medical University Salzburg, Salzburg, Austria. e.broussalis@salk.at.|Research Institute of Neurointervention, Paracelsus Medical University Salzburg, Salzburg, Austria. e.broussalis@salk.at.|Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria. e.broussalis@salk.at.|Department of Neuroradiology and Neurorology, Research Institute for Neurointervention, Paracelsus Medical University Salzburg, Ignaz-Harrerstrasse 79, 5020, Salzburg, Austria. e.broussalis@salk.at.
authors.forename: Erasmia
authors.identifier: http://orcid.org/0000-0003-0484-2427
authors.initials: E
authors.lastname: Broussalis
authors.affiliation: Department of Neuroradiology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Weymayr
authors.affiliation: Research Office, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Hitzl
authors.affiliation: Department of Neuroanesthesiology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: A F
authors.initials: AF
authors.lastname: Unterrainer
authors.affiliation: Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Trinka
authors.affiliation: Research Institute of Neurointervention, Paracelsus Medical University Salzburg, Salzburg, Austria.|Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Killer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000401:mortality / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D061185:Mechanical Thrombolysis / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000601:surgery*; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Cerebral artery occlusion; Octogenarians; Stroke; Thrombectomy; Vessel recanalization