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Mechanical thrombectomy in nonagenarians with acute ischemic stroke

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Mechanical thrombectomy in nonagenarians with acute ischemic stroke. / Meyer, Lukas; Alexandrou, Maria; Leischner, Hannes; Flottmann, Fabian; Deb-Chatterji, Milani; Abdullayev, Nuran; Maus, Volker; Politi, Maria; Roth, Christian; Kastrup, Andreas; Thomalla, Goetz; Mpotsaris, Anastasios; Fiehler, Jens; Papanagiotou, Panagiotis.

In: J NEUROINTERV SURG, Vol. 11, No. 11, 11.2019, p. 1091-1094.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Meyer, L, Alexandrou, M, Leischner, H, Flottmann, F, Deb-Chatterji, M, Abdullayev, N, Maus, V, Politi, M, Roth, C, Kastrup, A, Thomalla, G, Mpotsaris, A, Fiehler, J & Papanagiotou, P 2019, 'Mechanical thrombectomy in nonagenarians with acute ischemic stroke', J NEUROINTERV SURG, vol. 11, no. 11, pp. 1091-1094. https://doi.org/10.1136/neurintsurg-2019-014785

APA

Meyer, L., Alexandrou, M., Leischner, H., Flottmann, F., Deb-Chatterji, M., Abdullayev, N., Maus, V., Politi, M., Roth, C., Kastrup, A., Thomalla, G., Mpotsaris, A., Fiehler, J., & Papanagiotou, P. (2019). Mechanical thrombectomy in nonagenarians with acute ischemic stroke. J NEUROINTERV SURG, 11(11), 1091-1094. https://doi.org/10.1136/neurintsurg-2019-014785

Vancouver

Meyer L, Alexandrou M, Leischner H, Flottmann F, Deb-Chatterji M, Abdullayev N et al. Mechanical thrombectomy in nonagenarians with acute ischemic stroke. J NEUROINTERV SURG. 2019 Nov;11(11):1091-1094. https://doi.org/10.1136/neurintsurg-2019-014785

Bibtex

@article{dc4cf8e6e50644b8a56588c231f3870a,
title = "Mechanical thrombectomy in nonagenarians with acute ischemic stroke",
abstract = "BACKGROUND: Mechanical thrombectomy (MT) is a safe and effective therapy for ischemic stroke. Nevertheless, very elderly patients aged ≥90 years were either excluded or under-represented in previous trials. It remains uncertain whether MT is warranted for this population or whether there should be an upper age limit.METHODS: We retrospectively reviewed 79 patients with stroke aged ≥90 years from three neurointerventional centers who underwent MT between 2013 and 2017. Good functional outcome was defined as modified Rankin scale (mRS) ≤2 and assessed at 90-day follow-up. Successful recanalization was graded by Thrombolysis in Cerebral Infarction Scale (TICI) ≥2 b. Feasibility and safety assessments included unsuccessful recanalization attempts (TICI 0), time from groin puncture to recanalization, symptomatic intracranial hemorrhage (sICH), mortality, and intervention-related serious adverse events.RESULTS: Only occlusions within the anterior circulation were included. Median time from groin puncture to recanalization was 39 min (IQR 25-57 min). The rate of successful recanalization (TICI ≥2 b) was 69.6% (55/79). Good functional outcome (mRS ≤2) at 90 days was observed in 16% (12/75) of patients. In-hospital mortality was 29.1% (23/79) and increased significantly at 90 days (46.7%, 35/75; p<0.001). sICH occurred in 5.1% (4/79) of patients. No independent predictor for good functional outcome (mRS ≤2) at 90 days was identified through logistic regression analysis.CONCLUSION: MT in nonagenarians leads to high mortality rates and less frequently good functional outcome compared with younger patient cohorts in previous large randomized trials. However, MT appears to be safe and beneficial for a certain number of very elderly patients and therefore should generally not be withheld from nonagenarians.",
keywords = "Journal Article",
author = "Lukas Meyer and Maria Alexandrou and Hannes Leischner and Fabian Flottmann and Milani Deb-Chatterji and Nuran Abdullayev and Volker Maus and Maria Politi and Christian Roth and Andreas Kastrup and Goetz Thomalla and Anastasios Mpotsaris and Jens Fiehler and Panagiotis Papanagiotou",
note = "{\textcopyright} Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2019",
month = nov,
doi = "10.1136/neurintsurg-2019-014785",
language = "English",
volume = "11",
pages = "1091--1094",
journal = "J NEUROINTERV SURG",
issn = "1759-8478",
publisher = "BMJ PUBLISHING GROUP",
number = "11",

}

RIS

TY - JOUR

T1 - Mechanical thrombectomy in nonagenarians with acute ischemic stroke

AU - Meyer, Lukas

AU - Alexandrou, Maria

AU - Leischner, Hannes

AU - Flottmann, Fabian

AU - Deb-Chatterji, Milani

AU - Abdullayev, Nuran

AU - Maus, Volker

AU - Politi, Maria

AU - Roth, Christian

AU - Kastrup, Andreas

AU - Thomalla, Goetz

AU - Mpotsaris, Anastasios

AU - Fiehler, Jens

AU - Papanagiotou, Panagiotis

N1 - © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/11

Y1 - 2019/11

N2 - BACKGROUND: Mechanical thrombectomy (MT) is a safe and effective therapy for ischemic stroke. Nevertheless, very elderly patients aged ≥90 years were either excluded or under-represented in previous trials. It remains uncertain whether MT is warranted for this population or whether there should be an upper age limit.METHODS: We retrospectively reviewed 79 patients with stroke aged ≥90 years from three neurointerventional centers who underwent MT between 2013 and 2017. Good functional outcome was defined as modified Rankin scale (mRS) ≤2 and assessed at 90-day follow-up. Successful recanalization was graded by Thrombolysis in Cerebral Infarction Scale (TICI) ≥2 b. Feasibility and safety assessments included unsuccessful recanalization attempts (TICI 0), time from groin puncture to recanalization, symptomatic intracranial hemorrhage (sICH), mortality, and intervention-related serious adverse events.RESULTS: Only occlusions within the anterior circulation were included. Median time from groin puncture to recanalization was 39 min (IQR 25-57 min). The rate of successful recanalization (TICI ≥2 b) was 69.6% (55/79). Good functional outcome (mRS ≤2) at 90 days was observed in 16% (12/75) of patients. In-hospital mortality was 29.1% (23/79) and increased significantly at 90 days (46.7%, 35/75; p<0.001). sICH occurred in 5.1% (4/79) of patients. No independent predictor for good functional outcome (mRS ≤2) at 90 days was identified through logistic regression analysis.CONCLUSION: MT in nonagenarians leads to high mortality rates and less frequently good functional outcome compared with younger patient cohorts in previous large randomized trials. However, MT appears to be safe and beneficial for a certain number of very elderly patients and therefore should generally not be withheld from nonagenarians.

AB - BACKGROUND: Mechanical thrombectomy (MT) is a safe and effective therapy for ischemic stroke. Nevertheless, very elderly patients aged ≥90 years were either excluded or under-represented in previous trials. It remains uncertain whether MT is warranted for this population or whether there should be an upper age limit.METHODS: We retrospectively reviewed 79 patients with stroke aged ≥90 years from three neurointerventional centers who underwent MT between 2013 and 2017. Good functional outcome was defined as modified Rankin scale (mRS) ≤2 and assessed at 90-day follow-up. Successful recanalization was graded by Thrombolysis in Cerebral Infarction Scale (TICI) ≥2 b. Feasibility and safety assessments included unsuccessful recanalization attempts (TICI 0), time from groin puncture to recanalization, symptomatic intracranial hemorrhage (sICH), mortality, and intervention-related serious adverse events.RESULTS: Only occlusions within the anterior circulation were included. Median time from groin puncture to recanalization was 39 min (IQR 25-57 min). The rate of successful recanalization (TICI ≥2 b) was 69.6% (55/79). Good functional outcome (mRS ≤2) at 90 days was observed in 16% (12/75) of patients. In-hospital mortality was 29.1% (23/79) and increased significantly at 90 days (46.7%, 35/75; p<0.001). sICH occurred in 5.1% (4/79) of patients. No independent predictor for good functional outcome (mRS ≤2) at 90 days was identified through logistic regression analysis.CONCLUSION: MT in nonagenarians leads to high mortality rates and less frequently good functional outcome compared with younger patient cohorts in previous large randomized trials. However, MT appears to be safe and beneficial for a certain number of very elderly patients and therefore should generally not be withheld from nonagenarians.

KW - Journal Article

U2 - 10.1136/neurintsurg-2019-014785

DO - 10.1136/neurintsurg-2019-014785

M3 - SCORING: Journal article

C2 - 31030188

VL - 11

SP - 1091

EP - 1094

JO - J NEUROINTERV SURG

JF - J NEUROINTERV SURG

SN - 1759-8478

IS - 11

ER -