Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study
In Japan, which has a super-aging society, there are increasing opportunities to perform mechanical thrombectomy for the elderly; however, there is no recorded evidence of thrombectomy for the elderly. This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed pat...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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The Japan Neurosurgical Society
2023-09-01
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| Series: | Neurologia Medico-Chirurgica |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/nmc/63/9/63_2023-0039/_pdf/-char/en |
| _version_ | 1827798485123989504 |
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| author | Kohei SHIBUYA Hitoshi HASEGAWA Tomoaki SUZUKI Haruhiko TAKAHASHI Kei NISHIYAMA Makoto OISHI Yukihiko FUJII |
| author_facet | Kohei SHIBUYA Hitoshi HASEGAWA Tomoaki SUZUKI Haruhiko TAKAHASHI Kei NISHIYAMA Makoto OISHI Yukihiko FUJII |
| author_sort | Kohei SHIBUYA |
| collection | DOAJ |
| description | In Japan, which has a super-aging society, there are increasing opportunities to perform mechanical thrombectomy for the elderly; however, there is no recorded evidence of thrombectomy for the elderly. This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed patient data using a multicenter acute ischemic stroke registry (NGT-FAST). We examined outcomes in patients 75 years and older who underwent thrombectomies between January 1, 2021, and December 31, 2021. The patients were divided into two groups: the 75-84-year-old group and the 85+-year-old group. There was no difference in the pretreatment National Institutes of Health Stroke Scale score or Alberta Stroke Program Early Computed Tomography Score between the two groups, but the 85+-year-old group had a significantly lower rate of pre-stroke modified Rankin Scale (mRS) score of 0-2. There were no differences in time from onset to treatment or effective recanalization rate, but complications tended to be more common in the 85+-year-old group. The number of patients with a good outcome at discharge (an mRS score of 0-3) was significantly lower in the 85+-year-old group than in the 75-84-year-old group. In addition, 90.9% of patients in the 85+-year-old group with a pre-stroke mRS score of 3 deteriorated after treatment. The pre-stroke mRS score is very important in determining the indication for thrombectomy in the elderly because their preoperative condition is more likely to influence the outcome than that of younger patients. |
| first_indexed | 2024-03-11T19:37:21Z |
| format | Article |
| id | doaj.art-2c1caa59cef0474f9b8d2aedd922e3e6 |
| institution | Directory Open Access Journal |
| issn | 1349-8029 |
| language | English |
| last_indexed | 2024-03-11T19:37:21Z |
| publishDate | 2023-09-01 |
| publisher | The Japan Neurosurgical Society |
| record_format | Article |
| series | Neurologia Medico-Chirurgica |
| spelling | doaj.art-2c1caa59cef0474f9b8d2aedd922e3e62023-10-06T13:06:42ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292023-09-0163939339910.2176/jns-nmc.2023-00392023-0039Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter StudyKohei SHIBUYA0Hitoshi HASEGAWA1Tomoaki SUZUKI2Haruhiko TAKAHASHI3Kei NISHIYAMA4Makoto OISHI5Yukihiko FUJII6Department of Neurosurgery, Brain Research Institute, Niigata UniversityDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityDepartment of Emergency Medicine, Niigata UniversityDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityDepartment of Neurosurgery, Brain Research Institute, Niigata UniversityIn Japan, which has a super-aging society, there are increasing opportunities to perform mechanical thrombectomy for the elderly; however, there is no recorded evidence of thrombectomy for the elderly. This study examined the usefulness of thrombectomy in the elderly. We retrospectively analyzed patient data using a multicenter acute ischemic stroke registry (NGT-FAST). We examined outcomes in patients 75 years and older who underwent thrombectomies between January 1, 2021, and December 31, 2021. The patients were divided into two groups: the 75-84-year-old group and the 85+-year-old group. There was no difference in the pretreatment National Institutes of Health Stroke Scale score or Alberta Stroke Program Early Computed Tomography Score between the two groups, but the 85+-year-old group had a significantly lower rate of pre-stroke modified Rankin Scale (mRS) score of 0-2. There were no differences in time from onset to treatment or effective recanalization rate, but complications tended to be more common in the 85+-year-old group. The number of patients with a good outcome at discharge (an mRS score of 0-3) was significantly lower in the 85+-year-old group than in the 75-84-year-old group. In addition, 90.9% of patients in the 85+-year-old group with a pre-stroke mRS score of 3 deteriorated after treatment. The pre-stroke mRS score is very important in determining the indication for thrombectomy in the elderly because their preoperative condition is more likely to influence the outcome than that of younger patients.https://www.jstage.jst.go.jp/article/nmc/63/9/63_2023-0039/_pdf/-char/enelderlytreatment outcomeacute ischemic strokethrombectomymulticenter study |
| spellingShingle | Kohei SHIBUYA Hitoshi HASEGAWA Tomoaki SUZUKI Haruhiko TAKAHASHI Kei NISHIYAMA Makoto OISHI Yukihiko FUJII Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study Neurologia Medico-Chirurgica elderly treatment outcome acute ischemic stroke thrombectomy multicenter study |
| title | Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study |
| title_full | Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study |
| title_fullStr | Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study |
| title_full_unstemmed | Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study |
| title_short | Investigation of Mechanical Thrombectomy in Elderly Patients over 85 Years Old: A Multicenter Study |
| title_sort | investigation of mechanical thrombectomy in elderly patients over 85 years old a multicenter study |
| topic | elderly treatment outcome acute ischemic stroke thrombectomy multicenter study |
| url | https://www.jstage.jst.go.jp/article/nmc/63/9/63_2023-0039/_pdf/-char/en |
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