EXPRESS: Acute Stroke Treatment with Mechanical Thrombectomy without Iv tPA in Nonagenarian Patients: A Single Center Experience

BACKGROUND: Age is one of the most critical nonmodifiable risk factors for stroke. With the increasing aging of the global population, the incidence of stroke is expected to increase. The current evidence makes treatment decisions regarding MT in patients over 90 years of age challenging. The aim of this study is to evaluate the efficacy of MT and the factors associated with outcome in patients aged 90 years and older. METHODS: This is an observational study that follows STROBE guidelines. Patients aged 90 years and older with a pre-stroke mRS score of 0-1, proximal large vessel occlusion, and those who did not receive iv tPA were included in the study. A total of 28 patients were included. To assess clinical outcomes, the 90-day mRS score was evaluated. Patients were categorized into two groups: Good clinical outcome(mRS 0-2) and Poor clinical outcome (mRS 3-6). RESULTS: The mean age was 91.25±1.48 years. Female patients accounted for 71.4%. The mean NIHSS scores was 18.71±4.29. HT was the most common comorbidity. The admission glucose levels were significantly higher in the poor clinical outcome group(p=0.03). Type 3 aortic arch was significantly more frequent in the poor clinical outcome group. Isolated MCA occlusion was significantly more common in the good clinical outcome group(p=0.03). CONCLUSION: Our findings suggest that MT can be successful in certain patients in nonagenarian population. In this study, we identified that admission blood glucose level, aortic arch morphology, occluded vessels, and puncture-to-recanalization time are determinant factors for clinical outcomes.