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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Mechanical thrombectomy in stroke in nonagenarians: useful or futile?
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Mechanical thrombectomy in stroke in nonagenarians: useful or futile?

机译：在诺伊里人的中风中血栓切除术：有用还是徒劳的？

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Background: Mechanical thrombectomy is the standard treatment in acute ischemic stroke due to large vessel occlusion, but there is limited evidence about its efficacy in very old patients. We sought to analyse safety and effectiveness of mechanical thrombectomy in nonagenarian versus octagenarian patients. Methods: We included consecutive patients with acute ischemic stroke due to large vessel occlusion subjected to mechanical thrombectomy, during 29 months in a tertiary center. Patients were divided into two sub-groups, according to age: 80-89 and >90 years old. Recanalization, complications, functional outcome and mortality at discharge and at 3 months were compared. Multivariable analysis was performed to identify independent predictors of functional outcome at 3 months of follow-up, assessed by the modified Rankin Scale. Results: A total of 128 octogenarians (88.9%) and 16 nonagenarians (11.1%) met the inclusion criteria. Successful revascularization was achieved in 87.5% of octagenarians and in 81.3% of nonagenarians (p = 0.486). Symptomatic hemorrhage occurred in 3.1% and 6.3% of younger and older patients, respectively (p = 0.520). Cerebral edema occured in 35.2% of octagenarians versus 25.0% of nonagenarians (p = 0.419). Functional independence (mRS <= 2) at 3 months was achieved in 28 (22.6%) and 5 (31.3%) of octagenarians and nonagenarians, respectively (p = 0.445). Mortality at 3 months was not significantly higher in nonagenarians (37.5%) versus octagenarians (33.9%, p = 0.773). Conclusions: No significant diferences were found in functional outcome, mortality, recanalization and complication rates between octagenarians and nonagenarians submitted to mechanical thrombectomy, underlining that patients should not be excluded from mechanical thrombectomy based on age alone.
机译：背景：机械血栓切除术是大血管闭塞所致急性缺血性卒中的标准治疗方法，但其对高龄患者的疗效证据有限。我们试图分析机械血栓切除术在九岁和八岁患者中的安全性和有效性。方法：我们纳入了在一个三级中心连续29个月接受机械血栓切除术的因大血管闭塞而导致的急性缺血性中风患者。根据年龄将患者分为两个亚组：80-89岁和>90岁。比较出院时和3个月时的再通、并发症、功能结果和死亡率。进行多变量分析，以确定随访3个月时功能结果的独立预测因素，并采用改良的Rankin量表进行评估。结果：128名80岁老人（88.9%）和16名90岁老人（11.1%）符合纳入标准。87.5%的八岁老人和81.3%的九岁老人成功实现了血管重建（p=0.486）。年轻患者和老年患者的症状性出血发生率分别为3.1%和6.3%（p=0.520）。脑水肿发生率为35.2%的八岁老人和25.0%的九岁老人（p=0.419）。在三个月时，分别有28名（22.6%）和5名（31.3%）的八岁和九岁老人实现了功能独立（mRS<=2）（p=0.445）。九岁组（37.5%）与八岁组（33.9%，p=0.773）在3个月时的死亡率无显著性差异。结论：接受机械血栓切除术的八岁和九岁患者在功能结果、死亡率、再通率和并发症发生率方面没有发现显著差异，强调不应仅基于年龄将患者排除在机械血栓切除术之外。

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