Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke

OBJECTIVES: To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. DESIGN: Retrospective cohort study. SETTING: Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. PARTICIPANTS: Elderly adults treated for acute ischemic stroke (N = 219). MEASUREMENTS: Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, .99) or symptomatic (11% vs 14%, P = .6) ICH, or mortality (40.3% vs 29.2%, P = .14). Multivariable analysis revealed that, in the older group, onset National Institute of Health Stroke Scale (NIHSS) score (odds ratio (OR) = 0.65, 95% confidence interval (CI) = 0.44-0.96, P = .03) and 24-hour clinical improvement (OR = 141.13, 95% CI = 2.96-6,720.7, P = .01) were independent predictors of 3-month functional independence. CONCLUSION: These findings suggest that endovascular treatment for stroke in selected elderly adults could be safe and effective. Major determinants of outcome in this subgroup of elderly patients are presentation NIHSS score and 24-hour clinical improvement