Endovascular thrombectomy in young patients with stroke

Area of Science:

• Neurology
• Interventional Cardiology
• Vascular Surgery

Background:

• Endovascular treatment (ET) is a standard for acute ischemic stroke with large vessel occlusion.
• Limited data exist on ET outcomes specifically in young stroke patients.

Purpose of the Study:

• To compare outcomes of endovascular treatment in young (<50 years) versus older (>=50 years) acute ischemic stroke patients.
• To analyze functional outcomes and procedural parameters in a matched cohort.

Main Methods:

• Analysis of an observational multicenter cohort (German Stroke Registry-Endovascular Treatment trial).
• Comparison of baseline characteristics, procedural parameters, and 90-day functional outcomes.
• Nearest-neighbor 1:1 propensity score matching for young and older patient groups.

Main Results:

• Young patients (363/6628) had lower NIHSS scores and less prestroke dependence.
• Endovascular treatment was faster in young patients (35 vs. 45 min).
• Young patients showed significantly better outcomes: less intracranial hemorrhage (10.0% vs. 25.9%), higher good functional outcome (71.6% vs. 44.1%), and lower mortality (6.7% vs. 25.4%).

Conclusions:

• Young stroke patients undergoing ET achieve superior outcomes compared to matched older patients.
• Findings suggest potential for more liberal ET guidelines in younger stroke populations.
• Further research is warranted to establish evidence-based guidelines for ET in young stroke patients.