Intravenous thrombolysis for acute ischemic stroke in centenarians

Area of Science:

• Neurology
• Geriatrics
• Emergency Medicine

Background:

• Intravenous alteplase is a proven treatment for acute ischemic stroke.
• Limited data exists on alteplase efficacy and safety in centenarian patients.
• This study addresses the gap in knowledge for stroke treatment in the oldest population.

Purpose of the Study:

• To evaluate the outcomes of intravenous alteplase in patients aged 100 years and older with acute ischemic stroke.
• To assess the safety and functional recovery of centenarians treated with alteplase.
• To determine if thrombolysis is a beneficial treatment option for this specific demographic.

Main Methods:

• A descriptive study of centenarian patients treated with alteplase for acute ischemic stroke.
• Data collected from a single-center prospective registry.
• Clinical variables and functional outcomes (modified Rankin Scale) at 3 months were analyzed.

Main Results:

• Four functionally independent female patients (age >100) were included.
• Alteplase was administered within 4.5 hours of stroke onset.
• Two patients were independent at discharge (mRS ≤2), one improved to mRS 2 by 3 months. One patient died from pneumonia. No major adverse events were reported.

Conclusions:

• Intravenous thrombolysis with alteplase can be beneficial in selected centenarian patients.
• Treatment should be considered for patients over 100 years old with no prior functional disability.
• Further research is warranted to confirm these findings in a larger cohort.