Literature DB >> 20395387

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

Yince Loh1, D Kim, Z-S Shi, S Tateshima, P M Vespa, N R Gonzalez, S Starkman, J L Saver, R Jahan, D S Liebeskind, G R Duckwiler, F Viñuela.   

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.

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Year:  2010        PMID: 20395387      PMCID: PMC7965477          DOI: 10.3174/ajnr.A2079

Source DB:  PubMed          Journal:  AJNR Am J Neuroradiol        ISSN: 0195-6108            Impact factor:   3.825


  23 in total

1.  Trial design and reporting standards for intraarterial cerebral thrombolysis for acute ischemic stroke. 2003.

Authors: 
Journal:  J Vasc Interv Radiol       Date:  2003-08       Impact factor: 3.464

2.  Safety and efficacy of mechanical embolectomy in acute ischemic stroke: results of the MERCI trial.

Authors:  Wade S Smith; Gene Sung; Sidney Starkman; Jeffrey L Saver; Chelsea S Kidwell; Y Pierre Gobin; Helmi L Lutsep; Gary M Nesbit; Thomas Grobelny; Marilyn M Rymer; Isaac E Silverman; Randall T Higashida; Ronald F Budzik; Michael P Marks
Journal:  Stroke       Date:  2005-06-16       Impact factor: 7.914

3.  Risk factors for severe hemorrhagic transformation in ischemic stroke patients treated with recombinant tissue plasminogen activator: a secondary analysis of the European-Australasian Acute Stroke Study (ECASS II).

Authors:  V Larrue; R von Kummer R; A Müller; E Bluhmki
Journal:  Stroke       Date:  2001-02       Impact factor: 7.914

4.  Cerebral embolic ischemia in rats: correlation of stroke severity and functional deficit as important outcome parameter.

Authors:  Max Nedelmann; Thomas Wilhelm-Schwenkmezger; Beat Alessandri; Axel Heimann; Felicitas Schneider; B Martin Eicke; Marianne Dieterich; Oliver Kempski
Journal:  Brain Res       Date:  2006-12-08       Impact factor: 3.252

5.  Revascularization end points in stroke interventional trials: recanalization versus reperfusion in IMS-I.

Authors:  Pooja Khatri; Joddi Neff; Joseph P Broderick; Jane C Khoury; Janice Carrozzella; Thomas Tomsick
Journal:  Stroke       Date:  2005-10-13       Impact factor: 7.914

6.  MERCI 1: a phase 1 study of Mechanical Embolus Removal in Cerebral Ischemia.

Authors:  Y Pierre Gobin; Sidney Starkman; Gary R Duckwiler; Thomas Grobelny; Chelsea S Kidwell; Reza Jahan; John Pile-Spellman; Alan Segal; Fernando Vinuela; Jeffrey L Saver
Journal:  Stroke       Date:  2004-10-28       Impact factor: 7.914

7.  Baseline magnetic resonance imaging parameters and stroke outcome in patients treated by intravenous tissue plasminogen activator.

Authors:  N Nighoghossian; M Hermier; P Adeleine; L Derex; J F Dugor; F Philippeau; H Ylmaz; J Honnorat; P Dardel; Y Berthezène; J C Froment; P Trouillas
Journal:  Stroke       Date:  2003-02       Impact factor: 7.914

8.  Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis.

Authors:  David M Greer; Susan E Funk; Nancy L Reaven; Myrsini Ouzounelli; Gwen C Uman
Journal:  Stroke       Date:  2008-08-21       Impact factor: 7.914

9.  Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS)

Authors:  W Hacke; M Kaste; C Fieschi; D Toni; E Lesaffre; R von Kummer; G Boysen; E Bluhmki; G Höxter; M H Mahagne
Journal:  JAMA       Date:  1995-10-04       Impact factor: 56.272

10.  Stroke incidence, prevalence, and survival: secular trends in Rochester, Minnesota, through 1989.

Authors:  R D Brown; J P Whisnant; J D Sicks; W M O'Fallon; D O Wiebers
Journal:  Stroke       Date:  1996-03       Impact factor: 7.914

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  10 in total

1.  Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients: a position paper endorsed by ESMINT and ESNR : part I: Current situation and major research questions.

Authors:  Jens Fiehler; Michael Söderman; Francis Turjman; Philip M White; Søren Jacob Bakke; Salvatore Mangiafico; Rüdiger von Kummer; Mario Muto; Christophe Cognard; Jan Gralla
Journal:  Neuroradiology       Date:  2012-09-05       Impact factor: 2.804

2.  Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients - a position paper endorsed by ESMINT and ESNR : part II: methodology of future trials.

Authors:  Jens Fiehler; Michael Söderman; Francis Turjman; Philip M White; Søren Jacob Bakke; Salvatore Mangiafico; Rüdiger von Kummer; Mario Muto; Christophe Cognard; Jan Gralla
Journal:  Neuroradiology       Date:  2012-09-05       Impact factor: 2.804

3.  Recruitment of Ischemic Stroke Patients in Clinical trials in General Practice and Implications for Generalizability of Results.

Authors:  M Fareed; K Suri; Adnan I Qureshi
Journal:  J Vasc Interv Neurol       Date:  2012-06

4.  Endovascular mechanical recanalization of acute ischaemic stroke in octogenarians.

Authors:  Erasmia Broussalis; F Weymayr; W Hitzl; A F Unterrainer; E Trinka; M Killer
Journal:  Eur Radiol       Date:  2015-09-15       Impact factor: 5.315

5.  Patient selection for stroke endovascular therapy--DWI-ASPECTS thresholds should vary among age groups: insights from the RECOST study.

Authors:  F Danière; K Lobotesis; P Machi; O Eker; I Mourand; C Riquelme; X Ayrignac; J F Vendrell; G Gascou; J Fendeleur; C Dargazanli; R Schaub; H Brunel; C Arquizan; A Bonafé; V Costalat
Journal:  AJNR Am J Neuroradiol       Date:  2014-10-01       Impact factor: 3.825

6.  Impact of Merci device fracture on clinical outcome of acute ischemic stroke after mechanical thrombectomy.

Authors:  Zhong-Song Shi; Gary R Duckwiler; Yince Loh; David S Liebeskind; Nestor R Gonzalez; Satoshi Tateshima; Reza Jahan; Jeffrey L Saver; Fernando Viñuela
Journal:  CNS Neurosci Ther       Date:  2012-08-20       Impact factor: 5.243

7.  Impact of Baseline Ischemia on Outcome in Older Patients Undergoing Endovascular Therapy for Acute Ischemic Stroke.

Authors:  Yang Ha Hwang; Yong Won Kim; Dong Hun Kang; Yong Sun Kim; David S Liebeskind
Journal:  J Clin Neurol       Date:  2017-03-06       Impact factor: 3.077

8.  Significances and Outcomes of Mechanical Thrombectomy for Acute Infarction in Very Elderly Patients: A Single Center Experience.

Authors:  Dong Hun Kim; Sang Uk Kim; Jae Hoon Sung; Dong Hoon Lee; Ho Jun Yi; Sang Won Lee
Journal:  J Korean Neurosurg Soc       Date:  2017-10-25

9.  Multimodal endovascular management of acute ischemic stroke in patients over 75 years old is safe and effective.

Authors:  George M Ghobrial; Nohra Chalouhi; Lana Rivers; Samantha Witte; Justin Davanzo; Richard Dalyai; Michelle L Gardecki; Pascal Jabbour; Fernando Gonzalez; Aaron S Dumont; Robert H Rosenwasser; Stavropoula Tjoumakaris
Journal:  J Neurointerv Surg       Date:  2012-07-11       Impact factor: 5.836

Review 10.  Clinical Outcome after Intra-Arterial Stroke Therapy in the Very Elderly: Why is it so Heterogeneous?

Authors:  Ronil V Chandra; Thabele M Leslie-Mazwi; Brijesh P Mehta; Albert J Yoo; Claus Z Simonsen
Journal:  Front Neurol       Date:  2014-04-29       Impact factor: 4.003

  10 in total

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