Mechanical thrombectomy for elderly stroke patients: An updated systematic review and meta-analysis of randomized clinical trials
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: BackgroundAlthough multiple clinical trials have established the efficacy of mechanical thrombectomy (MT) in managing acute ischemic stroke (AIS) in the general population, its outcomes specifically in elderly patients remain uncertain. This study aims to evaluate the efficacy and safety of MT in elderly patients with AIS, providing a clearer understanding of its potential benefits in this population.MethodsWe searched PubMed, Embase, and Cochrane databases for randomized clinical trials (RCTs) comparing MT with standard medical management in patients with AIS, with data available for elderly patients (over 70 years). Outcomes included functional recovery (≥1-point mRS improvement), excellent (mRS 0-2), good (mRS 0-3), poor (mRS ≥5) outcomes, and mortality at 90 days. Pooled odds and risk ratios (OR and RR) with 95% confidence intervals (CIs) were estimated using a random-effects model.ResultsFifteen RCTs, involving 1481 elderly patients, were included. MT was associated with a better functional recovery (OR 1.54; 95% CI: 1.22-1.94; P < .01), higher rates of excellent (RR 1.60; 95% CI: 1.11-2.30; P = .01) and good (RR 1.84; 95% CI: 1.45-2.35; P < .01), and lower rates of poor functional outcomes (RR 0.71; 95% CI: 0.58-0.85; P < .01) and mortality (RR 0.65; 95% CI: 0.45-0.96; P = .03). Subgroup analyses based on age threshold (>80 years), anterior/posterior circulation, and country socioeconomic status were consistent with the overall results.ConclusionsThis updated meta-analysis suggests that MT may be associated with better functional outcomes and lower mortality in selected elderly patients with AIS; however, limited elderly specific safety data and selective trial populations warrant cautious interpretation.
Source: The Neuroradiology Journal
Authors: Leonardo Januário Campos Cardoso, Ahmet Günkan, Marcio Yuri Ferreira, Madhav Sambhu, Xiaoyi Gao, Christian Ken Fukunaga, Filipe Virgilio Ribeiro, Anderson Matheus Pereira da Silva, Elison Emanuel Araújo Lima, Ocílio Ribeiro Gonçalves, Ivan Petterson Santana Teixeira, Christian Ferreira, Yafell Serulle, David Stuart Gordon, Panagiotis Papanagiotou, Jean-Claude Baron
Institutions: Universidade Federal de Minas Gerais, University of Arizona, Northwell Health, Lenox Hill Hospital, Emory University, Centro Universitário Barão de Mauá, Universidade Federal do Vale do São Francisco, Universidade Federal de Roraima, Universidade Federal do Piauí, Klinikum Bremen-Mitte, Université Paris Cité
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7130344864