Achieving complete recanalization is the best predicting factor of good outcome for thrombectomy in the elderly.
Manar Abomulay1, Philippe Desfontaines2, Carla Ciobanu2
1Department of Neurology, Comprehensive Stroke Unit, CHC MontLegia, Liège, Belgium. manar.abomulay@student.uclouvain.be.
Background And Aims:
Little is known about predicting factors for a good outcome (GO) after endovascular treatment (EVT) performed for acute ischemic stroke (AIS) related to large vessel occlusion (LVO) in the over-80s population. We evaluate demographic and procedural predictors of GO from our prospective registry of patients treated during the acute phase of an LVO-related AIS.
Methods:
GO was defined as a 3-month modified Rankin scale (mRS) [Formula: see text] 3 or equivalent to pre-stroke mRS. Univariate (UVA) and multivariate (MVA) analysis were performed to assess the factors' independent effect on the outcome. The magnitude of the between-group differences was assessed by calculating the standardized differences (StD). Variables with StD >0,2 were included in the MVA.
Results:
From 182 patients aged ≥ 80, 3-month GO was observed in 31.3% (57/182). The proportion of TICI ≥ 2c-3 was significantly lower in the poor outcome (PO) group compared to the GO group (52% versus 78.9%, StD = 0.591). In univariate logistic regression model, TICI ≥ 2c-3 is associated with a 277% increase in the chances of a GO (OR = 3.77, 95%CI 1.79-7.97, P < 0.001). This association remained significant in multivariate logistic regression model (aOR = 0.77, 95%CI 0.66-0.89, P = 0.000501) even when a hemorrhagic transformation (HT) occurs (p het = 0.57948).
Conclusions:
We show that achieving a TICI score of 2c-3 seems to be the best predictive factor for the outcome in the elderly population. In this group, every effort should be made to achieve excellent recanalization.
