title: Successful endovascular stroke therapy in a 103-year-old woman.
abstract: People older than 80 years of age constitute the most rapidly growing age group in the world. Several trials confirming superior efficacy of endovascular therapy did not have an upper age limit and showed favorable treatment effects, regardless of age. Current American Heart Association/American Stroke Association guidelines do not restrict treatment based on age as long as other eligibility criteria are met. A 103-year-old woman presented 2 h after stroke onset secondary to a left internal carotid artery terminus (ICA-T) occlusion. Admission National Institutes of Health Stoke Scale (NIHSS) score was 38, with no early ischemic changes on imaging, pre-stroke modified Rankin Scale score was 0, and she lived independently with minimal help. After initiation of intravenous thrombolysis, the patient underwent successful mechanical thrombectomy with Thombosis in Cerebral Infaction-3 recanalization. She showed remarkable recovery (NIHSS score of 1 at 48 h). Stroke onset to recanalization was 3 h 40 min. Our objective in documenting the oldest patient to successfully undergo stroke intervention is to corroborate that with the current evidence, appropriate patients undergoing rapid treatment may allow us to advance the limits of endovascular therapy.
authors.affiliation: Department of Interventional Neuroradiology, West Virginia University, Morgantown, West Virginia, USA.
authors.forename: SoHyun
authors.initials: S
authors.lastname: Boo
authors.affiliation: Department of Neurology, West Virginia University, Morgantown, West Virginia, USA.
authors.forename: Uzoma B
authors.initials: UB
authors.lastname: Duru
authors.affiliation: Department of Neurology, West Virginia University, Morgantown, West Virginia, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Smith
authors.affiliation: Department of Interventional Neuroradiology, West Virginia University, Morgantown, West Virginia, USA.
authors.forename: Ansaar T
authors.initials: AT
authors.lastname: Rai
mesh_terms: D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology / Q000601:surgery; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D015600:Glasgow Coma Scale; D006801:Humans; D018810:Magnetic Resonance Angiography; D020127:Recovery of Function; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Stroke; Technique; Thrombectomy