E-019 Mechanical thrombectomy for nonagenarian with M1 occlusion: analysis from multicenter cohort
Year: 2021
Type: conference-abstract
Abstract: Introduction Elderly individuals are at an increased risk for stroke and are responsible for a substantial portion of the total stroke burden. The safety and efficacy of thrombectomy in nonagenarians is not fully understood, as they have traditionally been excluded from major endovascular trials. Recent literature suggests 7% of patients have functional independence at 3 months following medical management. This research aims to determine the outcomes of thrombectomy in patients ≥ 90 years with proximal intracranial occlusion. Methods We performed a multicenter retrospective analysis of consecutive acute ischemic stroke patients with M1 occlusion treated within 24 hours from the time of last known well who were greater than 89 years of age. Patient demographics, periprocedural metrics, and discharge and 90-day modified Rankin Scale (mRS) scores were collected. Successful recanalization was defined as TICI 2B or better. Favorable outcome was defined as 90-day mRS≤2 for patients prestroke mRS<2, and no worsening of prestroke mRS at 90-day in patients with prestrike mRS>2. Results Seventy-one patients over 89 years old were identified. Fifty-two (73.2%) were female. Pre-stroke mRS scores were available for 70 patients. The baseline median mRS was 2. Successful recanalization was achieved in 95.8% of patients. TICI 2C or greater was accomplished in 64.8% of cases. Functional outcome data at 90-days were available for 57 patients (80.2%). At three months, 7 total patients had an mRS between 0–2 (12.3%), and an additional 11 patients had an mRS of 3 (19.2%). The rate of 90-day mortality was 42%. Conclusions Mechanical thrombectomy in nonagenarians is technically feasible with high rate of successful reperfusion and it may improve clinical outcome. More research is needed to determine if thrombectomy results in significantly better functional outcomes than medical management for nonagenarians. Disclosures S. Majidi: None. J. Vargas: 2; C; Cerenovus, Medtronic. 4; C; Truvic. J. Blalock: None. H. Hawk: None. S. Nimjee: None. A. Zakeri: None. M. Mokin: 2; C; Medtronic, Cerenovus. 4; C; Endostream, Serenity medical. R. Kellogg: None. G. Cortez: None. A. Aghaebrahim: None. E. Sauvageau: None. R. Hanel: 1; C; Stryker, Medtronic. 2; C; Stryker, Medtronic, Balt, Cerenovus, Microvention, Q’Apel, Rapid Medical. 4; C; Scientia, RisT, Corindus. R. DeLeacy: None. A. Siddiqui: 1; C; NIH-NINDS R21 NS109575-01. 2; C; Cerenovus, Imperitive Care, Medtronic, Microvention, Penumbra, Q’Apel. 4; C; Imperitive Care, Q’Apel, Rist, Truvic. A. Turk: 2; C; Imperitive Care, Stryker, Microvention, Penumbra, BALT, Cerenovus. 4; C; Imperitive Care. M. Oselkin: None. E. Marlin: None. R. Turner: 2; C; Q’apel, Cerenovus, Siemens. 4; C; Q’APel. I. Chaudry: 2; C; Cerenovus, Q’Apel. 4; C; Q’Apel. J. Milburn: None.
Institutions: Mount Sinai Health System, Prisma Health, University of South Carolina, Erlanger Health System, The Ohio State University, University of South Florida, University of Virginia, Baptist Medical Center Jacksonville, University at Buffalo, State University of New York, St. Luke's University Health Network, Ochsner Health System
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W3184772275