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Mechanical Thrombectomy for Acute Ischemic Stroke in Nonagenarians: A Dilemma in Treatment Approach
Subash Phuyal1, Alamelu Alagappan2, Prakash Phuyal1
1Neuroimaging and Interventional Neuroradiology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, NPL.
Stroke is one of the major causes of mortality and morbidity, particularly among the elderly population. As the general population ages, cerebrovascular disease is anticipated to increase in prevalence. Strokes can manifest as either hemorrhagic or ischemic events. While mechanical thrombectomy is efficacious in the treatment of major arterial occlusion, many studies have excluded nonagenarians due to anticipated poor functional outcomes. The functional prognosis in nonagenarians is influenced by various factors, including procedural challenges related to vessel tortuosity, collateral circulation status, and multiple medical comorbidities. Herein, we report a case of acute ischemic stroke (AIS) in a nonagenarian male with major arterial occlusion successfully managed via mechanical thrombectomy, resulting in an excellent post-procedural outcome at the three-month follow-up.
Stroke is one of the major causes of mortality and morbidity, particularly among the elderly population. As the general population ages, cerebrovascular disease is anticipated to increase in prevalence. Strokes can manifest as either hemorrhagic or ischemic events. While mechanical thrombectomy is efficacious in the treatment of major arterial occlusion, many studies have excluded nonagenarians due to anticipated poor functional outcomes. The functional prognosis in nonagenarians is influenced by various factors, including procedural challenges related to vessel tortuosity, collateral circulation status, and multiple medical comorbidities. Herein, we report a case of acute ischemic stroke (AIS) in a nonagenarian male with major arterial occlusion successfully managed via mechanical thrombectomy, resulting in an excellent post-procedural outcome at the three-month follow-up.
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