Endovascular Stroke Treatment of Patients Over 80 Years Old: Cumulative Evidence from the “Real World”

Background Evidence on stent retriever-based thrombectomy (SRT) efficacy in elderly patients is controversial. This study aimed to analyze safety and efficacy outcomes in octogenarians submitted to SRT. Methods Analysis was based on a prospective observational registry of patients with stroke because of anterior circulation large-vessel occlusion treated with SRT at our center between January 2015 and September 2016. Patients were dichotomized into 2 age groups: ≤80 and >80 years old. Outcomes at 90 days were assessed: “excellent outcome” (a modified Rankin scale [mRs] score of 0-1) and “good outcome” (a mRs score of 0-2). Results A total of 141 patients were included: 35 (24.8%) >80 years old and 106 (71.2%) ≤80 years old; 43.4% of patients in the younger group and 25.7% of patients in the older group achieved an “excellent outcome.” A “good outcome” was achieved in 65.1% of patients in the younger group, and 60% of patients in the older group; crude odds ratio (OR) for “excellent outcome” was 0.452 ( P  = .067). Crude OR for “good outcome” was 0.804 ( P  = .587). After adjusting for gender, National Institutes of Health Stroke Scale score at admission, Alberta Stroke Program Early CT Score, and thrombolysis, the OR was 0.450 ( P  = .100) and 1.217 ( P  =  .686) for “excellent” and “good” outcomes, respectively. Conclusions In this cohort, 60% of elderly patients regained functional independence at 3 months after SRT. Although age may be a prognostic factor, patients should not be excluded from SRT based on age criteria.