Background Endovascular thrombectomy (EVT) is the established therapy for acute vertebrobasilar occlusions (VBAOs). However, the influence of advanced age and interhospital transfer on outcomes remains uncertain. Octogenarians may be particularly vulnerable to transfer‐related factors, yet multicenter data are limited. We sought to evaluate the impact of age (90%). In patients <80 years, outcomes were comparable between transfer and mothership presentations (mortality 41.1% vs. 49.3%, p=0.3; mRS 0‐3: 46.6% vs. 37.7%, p=0.2). By contrast, octogenarians presenting via transfer experienced worse outcomes (mortality 70.5% vs. 55.6%; mRS 0‐3: 18.2% vs. 38.9%), with significant interaction effects. After adjustment for baseline imbalances, the interaction effect demonstrated that mothership presentation in octogenarians was associated with markedly higher odds of functional independence (aOR 10.1, 95% CI 1.6‐64.2, interaction p=0.01) and reduced mortality (aOR 0.14, 95% CI 0.02‐0.88, interaction p=0.03). Conclusion This 10‐year multicenter experience demonstrates that octogenarians with VBO are disproportionately affected by interhospital transfer, with significantly lower functional independence and higher mortality compared to direct mothership presentation. Despite similar reperfusion rates, older patients showed reduced tolerance to transfer‐related factors. These findings highlight the need for age‐sensitive triage protocols that prioritize direct transport of elderly patients to thrombectomy‐capable centers. Optimizing EVT access for this high‐risk population may improve survival and functional recovery in VBO. image
Batista et al. (Sat,) studied this question.
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