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Mechanical Thrombectomy in Stroke in Nonagenarians: Useful or Futile?

2020Journal article Open access
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dc.contributor.authorMendes Pinto, M
dc.contributor.authorPaiva Nunes, A
dc.contributor.authorAlves, M
dc.contributor.authorPapoila, AL
dc.contributor.authorPamplona, J
dc.contributor.authorCarvalho, R
dc.contributor.authorBaptista, M
dc.contributor.authorReis, J
dc.contributor.authorFragata, I
dc.date.accessioned2022-04-29T14:34:51Z
dc.date.available2022-04-29T14:34:51Z
dc.date.issued2020
dc.description.abstractBackground: Mechanical thrombectomy is the standard treatment in acute ischemic stroke due to large vessel occlusion, but there is limited evidence about its efficacy in very old patients. We sought to analyse safety and effectiveness of mechanical thrombectomy in nonagenarian versus octagenarian patients. Methods: We included consecutive patients with acute ischemic stroke due to large vessel occlusion subjected to mechanical thrombectomy, during 29 months in a tertiary center. Patients were divided into two sub-groups, according to age: 80-89 and >90 years old. Recanalization, complications, functional outcome and mortality at discharge and at 3 months were compared. Multivariable analysis was performed to identify independent predictors of functional outcome at 3 months of follow-up, assessed by the modified Rankin Scale. Results: A total of 128 octogenarians (88.9%) and 16 nonagenarians (11.1%) met the inclusion criteria. Successful revascularization was achieved in 87.5% of octagenarians and in 81.3% of nonagenarians (p = 0.486). Symptomatic hemorrhage occurred in 3.1% and 6.3% of younger and older patients, respectively (p = 0.520). Cerebral edema occured in 35.2% of octagenarians versus 25.0% of nonagenarians (p = 0.419). Functional independence (mRS ≤ 2) at 3 months was achieved in 28 (22.6%) and 5 (31.3%) of octagenarians and nonagenarians, respectively (p = 0.445). Mortality at 3 months was not significantly higher in nonagenarians (37.5%) versus octagenarians (33.9%, p = 0.773). Conclusions: No significant diferences were found in functional outcome, mortality, recanalization and complication rates between octagenarians and nonagenarians submitted to mechanical thrombectomy, underlining that patients should not be excluded from mechanical thrombectomy based on age alone.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Stroke Cerebrovasc Dis. 2020 Sep;29(9):105015.pt_PT
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2020.105015.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4058
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSJ NEUpt_PT
dc.subjectHSJ NRADpt_PT
dc.subjectCHLC CINVpt_PT
dc.subjectMalept_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectAge Factorspt_PT
dc.subjectBrain Ischemia / diagnosispt_PT
dc.subjectBrain Ischemia / physiopathologypt_PT
dc.subjectBrain Ischemia / mortalitypt_PT
dc.subjectBrain Ischemia / therapypt_PT
dc.subjectClinical Decision-Makingpt_PT
dc.subjectDisability Evaluationpt_PT
dc.subjectHospital Mortalitypt_PT
dc.subjectPatient Dischargept_PT
dc.subjectPatient Selectionpt_PT
dc.subjectRecovery of Functionpt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectRisk Factorspt_PT
dc.subjectStroke / diagnosispt_PT
dc.subjectStroke / mortalitypt_PT
dc.subjectStroke / therapypt_PT
dc.subjectStroke / physiopathologypt_PT
dc.subjectThrombectomy* / adverse effectspt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectThrombectomy* / mortalitypt_PT
dc.subjectTime Factorspt_PT
dc.titleMechanical Thrombectomy in Stroke in Nonagenarians: Useful or Futile?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.startPage105015pt_PT
oaire.citation.titleJournal of Stroke and Cerebrovascular Diseasespt_PT
oaire.citation.volume29pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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