Higher rates of mortality but not morbidity follow intracranial mechanical thrombectomy in the elderly

AJNR Am J Neuroradiol. 2010 Aug;31(7):1181-5. doi: 10.3174/ajnr.A2079. Epub 2010 Apr 15.

Abstract

Background and purpose: Mechanical thrombectomy is a promising means of recanalizing acute cerebrovascular occlusions in certain situations. We sought to determine if increasing age adversely affects prognosis.

Materials and methods: We reviewed all Merci thrombectomy cases and compared patients younger than 80 years of age with older individuals. We compared these 2 age groups with respect to recanalization rates, hospital LOS, hemorrhagic transformation, and death and disability on discharge.

Results: Elderly patients were more likely to die from their stroke than those younger than 80 years of age, regardless of recanalization success (48% versus 15%; OR, 5.5; 95% CI, 2.1-14.1). Among survivors, there was no difference in the probability of having a good functional outcome (mRS, <or=2) by discharge (38% versus 40%; OR, 0.9; 95% CI, 0.3-2.8). Hemorrhagic transformation did not vary between age groups.

Conclusions: Among patients undergoing mechanical thrombectomy for acute cerebrovascular occlusions, increased age conveys a higher rate of stroke-related death, but disability at discharge in this group is similar to that of younger survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Disability Evaluation
  • Female
  • Humans
  • Intracranial Thrombosis / mortality*
  • Intracranial Thrombosis / surgery*
  • Male
  • Middle Aged
  • Morbidity
  • Prognosis
  • Stroke / mortality
  • Stroke / surgery
  • Thrombectomy / mortality*
  • Young Adult