Impact of Age and Baseline NIHSS Scores on Clinical Outcomes in the Mechanical Thrombectomy Using Solitaire FR in Acute Ischemic Stroke Study

Almekhlafi, Mohammed; Dávalos, Antonio; Bonafé, Alain; Chapot, René; Gralla, Jan; Pereira, Vítor Mendes; Goyal, Mayank

doi:10.3174/ajnr.a3855

Cited by 62 publications

(50 citation statements)

References 13 publications

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“…21,24,25 Furthermore, previous analysis of the STAR registry by using stratification by the Stroke Prognostication using Age and NIH Stroke Scale (SPAN) demonstrated poorer outcomes in patients with SPAN-100-positive scores, that is, patients with AIS in whom age ϩ presentation NIHSS were Ͼ100. 26 Of note, the baseline NIHSS score did not differ significantly between the older and younger groups in our study or indeed in the other studies comparing outcomes between the 2 age groups. This finding confirms the expectation that poorer outcomes are expected in older age groups unless good reperfusion is achieved.…”

Section: Discussionmentioning

confidence: 48%

TICI and Age: What's the Score?

Slater¹,

Coutinho²,

Gralla

et al. 2015

American Journal of Neuroradiology

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Section: Discussionmentioning

confidence: 48%

TICI and Age: What's the Score?

Slater¹,

Coutinho²,

Gralla

et al. 2015

American Journal of Neuroradiology

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“…8) However, in acute phase revascularization, the complication and mortality rates have been reported to be higher in older patients, and old age is considered an independent poor prognostic factor. 6,9,10) In this study, the percentage of patients in whom recanalization could be achieved with a single device, procedural time, and recanalization rate were all comparable between the older and control groups. While the time until placement of the guiding catheter was also comparable, the percentage of patients who required change of the approach difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 86%

Thrombectomy in Octogenarians in the Era of Stent Retriever: Is an Age Limit Necessary?

Tajima

Hayasaka

Ebihara

et al. 2017

JNET

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Objective:The results of thrombectomy in people aged 80 years and above were reviewed, and the necessity of an age limit was evaluated.Methods: Seventy eight patients who underwent thrombectomy at our hospital between July 2014 and September 2016 were divided into those aged <80 years and those aged ≥80 years, and the therapeutic results and outcome were evaluated. Results:The patients consisted of 25 aged ≥80 years (≥80 years group) and 53 aged <80 years (<80 years group). The mean time from puncture to recanalization was 56 and 65 minutes, respectively, and thrombolysis in cerebral infarction score of 2b or better recanalization was observed in 96.0 and 88.7%, respectively, with no significant difference in either parameter. Change of the approach route was necessary in five patients aged ≥80 years (20.0%). A favorable outcome with a modified Rankin scale (mRS) score of ≤2 was observed 3 months after the onset in 44.0 and 64.2%, respectively, being slightly lower in the ≥80 years group (P = 0.151). In the ≥80 years group, the time from the onset to recanalization was a poor prognostic factor (P = 0.048). Conclusion:In the patients aged ≥80 years, the recanalization rate, procedural time, and complication rate in thrombectomy were comparable to those in the patients aged <80 years, and no significant difference was observed in the outcome.Therefore, aggressive intervention without an age limit is considered recommendable in preoperatively activities of daily living (ADL)-independent elderly patients expected to be good candidates for simple thrombectomy. However, with the possibility of change in the approach route in mind, it is necessary to achieve recanalization more promptly in older patients.

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“…However, the analysis period was restricted to 2008-2010, the type of device used was not mentioned and treatment effect could not be assessed. 22 Almekhlafi et al 23 used the SPAN-100 index (i.e. positive index if age þ NIHSS score ¼ 100 or more) and found lower proportions of favorable outcome in the patients with positive (61%) compared to negative SPAN index (27%, OR 0.3; 95% CI 0.1-0.9), with 60% of positive SPAN index being 80 years of age and older.…”

Section: Aspects To Be Considered In Mechanical Thrombectomymentioning

confidence: 99%

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

Wahlgren

Moreira

Michel³

et al. 2015

International Journal of Stroke

328

227

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The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after

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Impact of Age and Baseline NIHSS Scores on Clinical Outcomes in the Mechanical Thrombectomy Using Solitaire FR in Acute Ischemic Stroke Study

Cited by 62 publications

References 13 publications

TICI and Age: What's the Score?

TICI and Age: What's the Score?

Thrombectomy in Octogenarians in the Era of Stent Retriever: Is an Age Limit Necessary?

Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

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