Abstract 213: Mechanical Thrombectomy in the Near‐Centennial

Introduction Life expectancy and quality of life are projected to continue rising in the United States, leading to a growing number of patients reaching the near‐centennial age. With this increasingly aging population, the number of elderly patients presenting with severe medical conditions, such as large vessel occlusions, is expected to increase. Despite advancements in mechanical thrombectomy, the safety in the elderly population remains poorly defined due to limited representation in clinical trials. This abstract retrospectively reviews the safety of mechanical thrombectomy in near‐centennial patients. Methods An IRB‐approved, prospectively maintained database was retrospectively reviewed to identify patients who underwent mechanical thrombectomy, yielding 20 cases in near‐centennial individuals. Demographic, clinical, and procedural data were collected, and outcomes were assessed using the TICI scale. Results A total of 20 cases were identified utilizing the mechanical thrombectomy technique in near‐centennial patients. The average age was 92.2 ± 0.5 years, with 14 females (70%). Patients presented with an NIHSS score of 15.5 ± 2.0. Thrombi were more commonly located in the right circulation (12 cases, 60%), primarily involving the M1 segment (13 cases, 65%) and M2 segment (7 cases, 35%). All cases (20, 100%) used a combination of stentriever and aspiration technique. TICI scores following intervention were TICI 3 in 12 cases (60%), TICI 2C in 6 cases (30%), and TICI 2B in 2 cases (10%) with an average of 1.6 ± 0.18 passes. 5 patients (20%) passed post‐procedure due to withdrawal of care in presence of severe disabling symptoms. This cohort of patients presented with an average NIHSS of 16.8 ± 1.5 and achieved TICI 3 and 2C in 2 cases and 3 cases, respectively. Conclusion In this series of near‐centennial patients, mechanical thrombectomy achieved high recanalization rates with acceptable safety despite age and high stroke severity. Care was withdrawn by family from only 20% of the patients, suggesting a large majority of patients may benefit from possible clinical improvement. These results suggest that age alone should not be the determining factor preventing patients from receiving mechanical thrombectomy when otherwise clinically appropriate. Additional multicenter studies are needed to better define outcomes and establish a criteria for patient selection in this population. image