ArticleClinical interventions in aging2026
Safety and Clinical Outcomes of Endovascular Thrombectomy in Very Elderly Patients (≥80 Years) with Acute Ischemic Stroke: A Prospective Multicenter Cohort Study in Vietnam.
Article in Clinical interventions in aging, 2026. 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
Background: Evidence on the safety and clinical outcomes of endovascular thrombectomy (EVT) in very elderly patients with acute ischemic stroke remains limited, particularly in low- and middle-income countries. Purpose: To evaluate the safety and clinical outcomes of EVT in patients aged ≥80 years with acute ischemic stroke. Patients and methods: This prospective multicenter cohort study was conducted at three major stroke centers in Vietnam between 2024 and 2025. Patients aged ≥80 years with acute ischemic stroke due to anterior circulation large vessel occlusion were enrolled. The primary outcome was functional independence at 90 days. Secondary outcomes included malignant cerebral edema, intracranial hemorrhage (ICH), and mortality. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: A total of 370 patients were included (190 EVT, 180 non-EVT). In adjusted analyses, EVT was associated with a higher likelihood of functional independence at 90 days (aOR 2.84, 95% CI 1.38-5.87; p=0.005) and a lower risk of malignant cerebral edema during hospitalization (aOR 0.50, 95% CI 0.27-0.93; p=0.029). EVT was also associated with a higher risk of any intracranial hemorrhage (aOR 4.78, 95% CI 2.90-7.89; p<0.001) and symptomatic intracranial hemorrhage (aOR 4.11, 95% CI 1.42-11.91; p=0.009). Although mortality at 90 days was numerically lower in the EVT group, the association did not reach statistical significance after adjustment (aOR 0.78, 95% CI 0.49-1.24; p=0.29). Conclusion: In very elderly patients with acute ischemic stroke, EVT was associated with improved functional outcomes but an increased risk of intracranial hemorrhage, without a significant increase in mortality. These findings support individualized treatment decision-making regarding EVT in carefully selected patients aged ≥80 years and highlight the importance of greater inclusion of very elderly populations in future clinical trials.
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