Acute Stroke Intervention In Young Patients

Abstract

Purpose: Stroke is a disease of the elderly, however it can affect the younger patients. We present a retrospective review of our series of young patients (55 years old and younger), treated at our institution from 2007 to 2012, to assess the safety, efficacy and patient outcome of multimodal endovascular treatment in this patient population. Methods: A total of 42 patients underwent multimodal endovascular revascularization for acute ischemic events. Recanalization rates were assessed using the Thrombolysis in Myocardial Infarction (TIMI)and clinical outcomes were assessed using the Modified Rankin Scale (mRS) obtained at discharge and follow-up visits. Patient demographics, medical co-morbidities, treatment complications and mortality data were collected and analyzed. Results: Of 42 patients, an improvement in Thrombolysis in Myocardial Infarction score (TIMI score) was noted in 38 patients (90.47%). The average modified Rankin Scale score on discharge was 3.2 with 25 patients (60%) having a favorable score of 0-3. All 21 patients (100%) with available clinical follow-up had a favorable mRS score (mean follow-up of 10.4 months). Symptomatic intracranial hemorrhage occurred in four patients (9.5%); none required surgery. Three fatalities resulted from intraoperative vessel rupture (7.14%). Conclusion: We observed good recanalization rates and favorable clinical outcomes after endovascular stroke intervention in young patients. Also, there was a low morbidity and mortality rate overall. Therefore multimodal endovascular recanalization of acute ischemic stroke is an effective treatment in younger patients, which justifies aggressive management of those patients.