非常老年人 (≥85岁) 内血管血栓切除术:来自高容量中风中心的结果
Ludwig Singer1, Maximilian Sprügel2, Stefan W Hock2
1From the Department of Neuroradiology (L.S., M.S, S.W.H., T.E.), University Hospital Erlangen and Department of Neurology (D.H., B.K., S.S., K.M.), University Hospital Erlangen. Ludwig.Singer@uk-erlangen.de.
AJNR. American journal of neuroradiology
|February 6, 2026
概括
急性缺血性中风的内血管治疗 (EVT) 在老年患者 (≥85岁) 中是可行的,但与较高的死亡率和较差的功能恢复有关. 在这种年龄段,中风前状态对于指导治疗决策至关重要.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 老年医学 老年医学
背景情况:
- 内血管治疗 (EVT) 是急性缺血性中风 (AIS) 与大血管封闭 (LVO) 的标准.
- 晚年对EVT结果的影响尚未得到充分证实.
- 这项研究调查了老年患者 (≥85岁) 与年轻人队伍的EVT结果.
研究的目的:
- 评估EVT在老年患者 (≥85岁) 的安全性和有效性.
- 为了比较老年人和年轻患者之间的EVT结果,由于LVO导致AIS.
- 确定影响老年患者进行EVT的功能恢复的因素.
主要方法:
- 从STAMINA数据库对581名前部循环LVO患者进行EVT的回顾性分析.
- 患者分为两组:≥85岁 (n=95) 和<85岁 (n=486).
- 主要结局:90天后功能恢复 (mRS ≤中风前mRS或中风前mRS +1). 二级结局:良好的功能结局 (mRS ≤2),死亡率,成功的EVT (TICI ≥ 2b) 和症状性脑内出血 (sICH).
主要成果:
- 与年轻患者相比,老年患者的90天死亡率 (53.8%与22.3%) 和良好的功能结果率 (1.1%与27.0%) 显著较高,并且较低.
- 在老年人群中,功能恢复率较低 (13.7%对21.0%),但在统计学上并不显著 (p=0.14).
- 症状性脑内出血的发病率在两组之间相似 (12.6%对比8.8%). 在中风前的mRS是老年人不良结果的重要预测因素.
结论:
- 在老年患者 (≥85岁) 中,由于LVO导致的AIS,EVT在技术上是可行的.
- 老年患者经历了更糟糕的功能结果和EVT后更高的死亡率.
- 年龄本身不应该排除EVT;然而,中风前的功能状态对于明智的,个性化的治疗决策至关重要.
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