ArticleNeurologia medico-chirurgica2025
Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age.
Article in Neurologia medico-chirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The effectiveness of endovascular therapy for patients aged 90 years and over (≥90 years) is still not well understood. We compared the patients aged ≥90 years with those aged 85-89 years, 80-84 years, and <80 years using data from the Japanese Registry of NeuroEndovascular Therapy that enrolled acute large vessel occlusion patients from January 2015 to December 2019. The primary outcome was the rate of return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days. Secondary outcomes were the incidences of intracranial hemorrhage and mortality.Among 13,540 patients, patients aged ≥90 years, 85-89 years, 80-84 years, and <80 years were 1,104, 1,925, 2,477, and 8,034. The prevalence of female gender, the premorbid Rankin Scale, and the National Institutes of Health Stroke Scale score before endovascular therapy were highest in the patients aged ≥90 years (n [%], 819 [74.2]; median [interquartile range]; 2 [0-3], and 21 [15-26]). The primary outcome of the adjusted odds ratio (95% confidence intervals) for the patients aged 85-89 years, 80-84 years, and <80 years for ≥90 years was 0.89 (0.72-1.10), 0.95 (0.77-1.16) and 1.07 (0.89-1.28). However, the incidence of symptomatic intracranial hemorrhage was lower in patients aged ≥90 years compared with patients aged 85-89 years and <80 years (adjusted odds ratio [95% confidence intervals]; 1.86 [1.16-2.98] and 1.71 [1.11-2.64]). The return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days in patients aged ≥90 years with large vessel occlusion was not significantly different in other groups but symptomatic intracranial hemorrhage was less observed than in younger patients.
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