Abstract DP229: Real-World Effectiveness of CTP-Based Endovascular therapy (EVT) in Elderly: Outcomes between Large Vessel and Medium Vessel Occlusions

Introduction: There is limited data regarding optimizing selection of elderly patients (age ≥80 years) with CT Perfusion (CTP) for endovascular thrombectomy (EVT). We aimed to evaluate outcomes in elderly patients selected for EVT with CTP compared to younger patients. Methods: A retrospective study from a large academic medical center. Patients with occlusion and treated with EVT between December 2017 and December 2024 were included in this study. Patients were excluded if: CTP completed after EVT, CTP failed or missing baseline or 90-day modified Rankin Scale scores (mRS). We compared nonagenarians (≥90 years old), octogenarians (80-89 years old) and younger patients (0.05. Elderly patients with fast progressing core volumes had worse 90-day outcomes compared to elderly patients with slow progressing cores, aOR = 0.3995%CI 0.27 – 0.57, P<0.001. Elderly patients with MeVO were less likely to achieve a good functional outcome at 90 days compared to younger patients, all P<0.05. Conclusions: Elderly patients, especially nonagenarians, were less likely to achieve good functional outcomes after EVT. Ischemic core growth was associated with outcomes in elderly patients and may be a variable to consider for better outcomes in these patients.