BACKGROUND The number of elderly patients suffering from ischemic stroke is rising. Randomized trials of mechanical thrombectomy (MT) generally exclude patients over the age of 80 years with baseline disability. The aim of this study was to understand the efficacy and safety of MT in elderly patients, many of whom may have baseline impairment. METHODS Between January 2015 and April 2017, 96 patients ≥80 years old who underwent MT for stroke were selected for a chart review. The data included baseline characteristics, time to treatment, the rate of revascularization, procedural complications, mortality, and 90-day good outcome defined as a modified Rankin Scale (mRS) score of 0-2 or return to baseline. RESULTS Of the 96 patients, 50 had mild baseline disability (mRS score 0-1) and 46 had moderate disability (mRS score 2-4). Recanalization was achieved in 84% of the patients, and the rate of symptomatic hemorrhage was 6%. At 90 days, 34% of the patients had a good outcome. There were no significant differences in good outcome between those with mild and those with moderate baseline disability (43 vs. 24%, p = 0.08), between those aged ≤85 and those aged > 85 years (40.8 vs. 26.1%, p = 0.19), and between those treated within and those treated beyond 8 h (39 vs. 20%, p = 0.1). The mortality rate was 38.5% at 90 days. The Alberta Stroke Program Early CT Score (ASPECTS) and the National Institutes of Health Stroke Scale (NIHSS) predicted good outcome regardless of baseline disability (p < 0.001 and p = 0.009, respectively). CONCLUSION Advanced age, baseline disability, and delayed treatment are associated with sub-optimal outcomes after MT. However, redefining good outcome to include return to baseline functioning demonstrates that one-third of this patient population benefits from MT, suggesting the real-life utility of this treatment.

中文翻译：

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具有轻度至中度基线残疾的老年中风患者的机械血栓切除术。

背景技术患有缺血性中风的老年患者的数量正在增加。机械血栓切除术 (MT) 的随机试验通常排除 80 岁以上有基线残疾的患者。本研究的目的是了解 MT 在老年患者中的疗效和安全性，其中许多患者可能有基线损伤。方法 2015 年 1 月至 2017 年 4 月，选择 96 例 80 岁以上因卒中接受 MT 的患者进行图表回顾。数据包括基线特征、治疗时间、血运重建率、手术并发症、死亡率和定义为 0-2 或返回基线的改良 Rankin 量表 (mRS) 评分的 90 天良好结果。结果 在 96 名患者中，50 名基线残疾（mRS 评分 0-1）和 46 名中度残疾（mRS 评分 2-4）。84%的患者实现了再通，症状性出血率为6%。在 90 天时，34% 的患者预后良好。轻度和中度基线残疾（43 对 24%，p = 0.08）、≤85 岁和 > 85 岁（40.8 对 26.1%，p = 0.19），以及在 8 小时内治疗和 8 小时以上治疗之间（39 对 20%，p = 0.1）。90天死亡率为38.5%。阿尔伯塔省卒中计划早期 CT 评分 (ASPECTS) 和美国国立卫生研究院卒中量表 (NIHSS) 预测无论基线残疾如何，预后良好（分别为 p < 0.001 和 p = 0.009）。结论 高龄、基线残疾和延迟治疗与 MT 后的次优结果相关。然而，