A root-cause analysis of poor prognosis in patients aged 80 years and over with acute ischemic stroke after mechanical thrombectomy / 中华老年医学杂志

ABSTRACT

Objective To explore the safety and effectiveness of mechanical thrombectomy in patients ≥80 years old,and to analyze the causes of poor prognosis.Methods The data of twenty consecutive patients ≥ 80 years old with acute ischemic stroke who underwent mechanical thrombectomy in our hospital from January 2017 to June 2018 were retrospectively reviewed.Baseline information,imaging data,thrombectomy procedures,complications,and clinical prognosis were collected.The causes of poor prognosis were analyzed.Results A total of 20 advanced age patients were included,with an average age of (83.3±4.1)years(range 80 to 96 years).All patients underwent mechanical thrombectomy,and the successful recanalization rate(mTICI 2b-3)was 70 ％.The incidence of technical complications was 15％,of which the rate of symptomatic intracranial hemorrhage was 5％.Among the 11 patients with poor prognosis,the causes included the severe diseases and later revascularization in 2 patients,unsuccessful recanalization or complications in 3 cases,and advanced age-related factors in 6 cases,among which there were accompanied multiple severe stenoses,poor collaterals and the rapid progress of stroke in 3 cases and the aggravation of previous comorbidities in 3 cases.Conclusions The advanced age patients ≥80 years old often have more comorbidities,higher prevalence rates of multiple severe vascular stenosis except the occluded vessels,poor collateral compensation and the aggravation of original comorbidities.And all of them may be important factors for the poor prognosis after mechanical thrombectomy.