ArticleMayo Clinic proceedings2009
Outcomes of intravenous tissue plasminogen activator for acute ischemic stroke in patients aged 90 years or older.
Article in Mayo Clinic proceedings, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 47 citations in OpenAlex.
- Article
- Outcomes of reperfusion therapy for acute ischaemic stroke in patients aged 90 years or older: a retrospective study.Internal and emergency medicine · 2021Article
- Prevention and Treatment of Acute Stroke in the Nonagenarians and Beyond: Medical and Ethical Issues.Current treatment options in neurology · 2019Review
- Stroke. Support for IV tPA in ischaemic stroke in elderly people.Nature reviews. Neurology · 2016Article
- Aspect of thrombolytic therapy: a review.TheScientificWorldJournal · 2014Review
- The Potential Impact of Maintaining a 3-Hour IV Thrombolysis Window: How Many More Patients can we Safely Treat?Journal of neurological disorders & stroke · 2013Article
- Prestroke dementia is associated with poor outcomes after reperfusion therapy among elderly stroke patients.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2013Article
- Effectiveness of alteplase in the very elderly after acute ischemic stroke.Clinical interventions in aging · 2013Review
- Autologous intravenous bone marrow mononuclear cell therapy for patients with subacute ischaemic stroke: a pilot study.The Indian journal of medical research · 2012Article
- Predictors of increased intravenous tissue plasminogen activator use among hospitals participating in the Massachusetts Primary Stroke Service Program.Circulation. Cardiovascular quality and outcomes · 2012Article
- Safety of thrombolysis in patients over the age of 80.The neurologist · 2012Article
- Strain tunes proteolytic degradation and diffusive transport in fibrin networks.Biomacromolecules · 2012Article
- Delayed cerebral ischemia and spreading depolarization in absence of angiographic vasospasm after subarachnoid hemorrhage.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2012Article
- Intravenous thrombolytic treatment in the oldest old.Stroke research and treatment · 2012Article
- Impact of tissue plasminogen activator on the neurovascular unit: from clinical data to experimental evidence.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2011Review
- Article
- Thrombolysis for cerebral ischemia.Frontiers in neurology · 2010Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although age is a major risk factor for stroke, physicians are often reluctant to use thrombolytic agents in those who are very old. No published study provides detailed information on the use of intravenous tissue plasminogen activator (tPA) in patients aged 90 years or older. We retrospectively reviewed the use of intravenous tPA for patients 90 years or older who were admitted with acute ischemic stroke to the hospital at 4 academic centers from March 1, 1999, to March 1, 2008. We reviewed the clinical features of the patients at presentation, complications, and outcomes. Twenty-two patients (11 women; median age, 93 years; range, 90-101 years) were identified who had received intravenous tPA for symptoms of acute ischemic stroke (average time to treatment, 143 minutes; range, 90-180 minutes; no tPA protocol violations; mean National Institutes of Health Stroke Scale score, 15; range, 5-28). Nearly all patients were highly functional at baseline (median modified Rankin Scale [mRS] score, 1; median Barthel Index score, 95), and all but one performed the activities of daily living with little or no assistance before stroke. By the 30-day follow-up, 2 patients (9%) had a favorable outcome (mRS score, 0-2) and 2 (9%) had moderate disability (mRS score, 3). Most patients died (n=10) or experienced severe disability, defined as an mRS score of 4 or 5 (n=5). Asymptomatic intracerebral hemorrhage occurred in 3 patients (14%) and was nonfatal. Most patients aged 90 years or older who received intravenous tPA for acute ischemic stroke had poor 30-day functional outcomes or died. Intravenous tPA treatment in this age group does not improve the outcome of ischemic stroke.
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