ArticleAJNR. American journal of neuroradiology2015
Patient selection for stroke endovascular therapy--DWI-ASPECTS thresholds should vary among age groups: insights from the RECOST study.
Article in AJNR. American journal of neuroradiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Mechanical thrombectomy versus medical care alone in large ischemic core: An up-to-date meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Pooled it
- Age Is an Effect Modifier of Thrombectomy Benefit in a Socioeconomically Vulnerable Stroke Population.Annals of neurology · 2026Trial
- Stroke Thrombectomy in the Elderly: Efficacy, Safety, and Special Considerations.Stroke (Hoboken, N.J.) · 2023Review
- Sex-specific differences in presentations and determinants of outcomes after endovascular thrombectomy for large vessel occlusion stroke.Journal of neurology · 2022Article
- Outcomes and CT Perfusion Thresholds of Mechanical Thrombectomy for Patients With Large Ischemic Core Lesions.Frontiers in neurology · 2022Article
- Observational
- Long-term outcome changes after mechanical thrombectomy for anterior circulation acute ischemic stroke.Journal of neurology · 2020Article
- Single Centre Experience on Decision Making for Mechanical Thrombectomy Based on Single-Phase CT Angiography by Including NCCT and Maximum Intensity Projection Images - A Comparison with Magnetic Resonance Imaging after Non-Contrast CT.Journal of Korean Neurosurgical Society · 2020Article
- DWI-Based Algorithm to Predict Disability in Patients Treated with Thrombectomy for Acute Stroke.AJNR. American journal of neuroradiology · 2020Observational
- Predictors of Catastrophic Outcome after Endovascular Thrombectomy in Elderly Patients with Acute Anterior Circulation Stroke.Korean journal of radiology · 2020Article
- Mechanical Thrombectomy in Ischemic Stroke Patients With Alberta Stroke Program Early Computed Tomography Score 0-5.Stroke · 2019Article
- Review
- Endovascular stroke treatment's impact on malignant type of edema (ESTIMATE).Journal of neurology · 2019Article
- Mechanical Thrombectomy in Anterior Circulation Occlusion Could Be More Effective than Medical Management Even in Low DWI-ASPECTS Patients.Neurologia medico-chirurgica · 2018Article
- Mechanical Thrombectomy in Elderly Stroke Patients with Mild-to-Moderate Baseline Disability.Interventional neurology · 2018Article
- Imaging assessment of acute ischaemic stroke: a review of radiological methods.The British journal of radiology · 2018Review
- Cerebral infarct volume measurements to improve patient selection for endovascular treatment.Medicine · 2016Observational
- Endovascular Management of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection Using a Distal to Proximal Approach: Insight from the RECOST Study.AJNR. American journal of neuroradiology · 2016Article
- Outcomes Are Not Different between Patients with Intermediate and High DWI-ASPECTS after Stent-Retriever Embolectomy for Acute Anterior Circulation Stroke.AJNR. American journal of neuroradiology · 2016Article
- TICI and Age: What's the Score?AJNR. American journal of neuroradiology · 2016Article
Corrections and comments
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeThe purpose of this study was to evaluate the benefits of endovascular intervention in large-vessel occlusion strokes, depending on age class. MATERIALS AND
methodsA clinical management protocol including intravenous treatment and mechanical thrombectomy was instigated in our center in 2009 (Prognostic Factors Related to Clinical Outcome Following Thrombectomy in Ischemic Stroke [RECOST] study). All patients with acute ischemic stroke with an anterior circulation major-vessel occlusion who presented within 6 hours were evaluated with an initial MR imaging examination and were analyzed according to age subgroups (younger than 50 years, 50-59 years, 60-69 years, 70-79 years; 80 years or older). The mRS score at 3 months was the study end point.
resultsOne hundred sixty-five patients were included in the analysis. The mean age was 67.4 years (range, 29-90 years). The mean baseline NIHSS score was 17.24 (range, 3-27). The mean DWI-derived ASPECTS was 6.4. Recanalization of TICI 2b/3 was achieved in 80%. At 3 months, 41.72% of patients had a good outcome, with a gradation of prognosis depending on the age subgroup and a clear cutoff at 70 years. Only 19% of patients older than 80 years had a good outcome at 3 months (mean ASPECTS = 7.4) with 28% for 70-79 years (mean ASPECTS = 6.8), but 58% for 60-69 years (mean ASPECTS = 6), 52% for 50-59 years (mean ASPECTS = 5.91), and 72% for younger than 50 years (mean ASPECTS = 6.31). In contrast, the mortality rate was 35% for 80 years and older, and 26% for 70-79 versus 5%-9% for younger than 70 years.
conclusionsThe elderly may benefit from thrombectomy when their ischemic core volume is low in comparison with younger patients who still benefit from acute recanalization despite larger infarcts. Stroke volume thresholds should, therefore, be related and adjusted to the patient's age group.
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