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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.8K

Endovascular Treatment for Acute Ischemic Stroke Patients over 80 Years of Age

Kihwan Hwang1, Gyojun Hwang1, O-Ki Kwon1

  • 1Department of Neurosurgery, Regional Caridocerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea.

Journal of Cerebrovascular and Endovascular Neurosurgery
|November 3, 2015
PubMed

Insights

Endovascular treatment (EVT) improves functional outcomes for acute ischemic stroke patients over 80. EVT reduces hospital infections but increases symptomatic hemorrhage risk without raising mortality.

Area of Science:

  • Neurology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • Acute ischemic stroke poses significant risks, particularly in elderly populations (over 80).
  • Endovascular treatment (EVT) is a potential intervention, but its efficacy and safety in octogenarians require specific evaluation.
  • Assessing outcomes in this demographic is crucial for optimizing stroke care guidelines.

Purpose of the Study:

  • To evaluate the effectiveness and safety of endovascular treatment (EVT) in patients aged 80 and above with acute ischemic stroke.
  • To compare functional outcomes, symptomatic hemorrhage rates, and in-hospital morbidity and mortality between EVT and non-EVT groups in this elderly cohort.
  • To determine if EVT offers a net benefit for octogenarian stroke patients.

Main Methods:

  • Retrospective analysis of 156 acute stroke patients over 80 years old.
  • Comparison of outcomes between 56 patients who underwent EVT and 100 who did not.
  • Statistical adjustments for age, time from onset, NIH Stroke Scale, and pre-stroke mRS.

Main Results:

  • EVT significantly improved good functional outcomes at 3 and 12 months (35.7% vs. 11.0% and 14.0%, respectively).
  • EVT group had lower rates of hospital-acquired pneumonia and urinary tract infections.
  • EVT group experienced more symptomatic hemorrhages (10.7% vs. 2.0%), but in-hospital mortality rates were similar.

Conclusions:

  • Endovascular treatment enhances functional recovery in acute ischemic stroke patients over 80.
  • EVT reduces the incidence of hospital-acquired infections in this population.
  • While EVT increases symptomatic hemorrhage risk, it does not elevate in-hospital mortality, suggesting a favorable risk-benefit profile for selected elderly patients.
Abstract

Keywords:
AgedStrokeThrombolytic therapy

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