What is the clinical evidence from this study?

Study design: Cohort. Population: Acute ischemic stroke (n=2254). Intervention: Age ≥75 years vs. Age <75 years. Primary outcome: Symptomatic intracranial hemorrhage (SICH) (p=0.04).

November 24, 2011American Journal of NeuroradiologyOpen Access

Interventional Stroke Therapies in the Elderly: Are We Helping?

Q: What are the key findings of this study?

Patients aged 75 years or older undergoing endovascular therapy for acute ischemic stroke had significantly higher rates of symptomatic intracranial hemorrhage (24% vs 9%) and in-hospital mortality (46% vs 26%) compared to younger patients.

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Why the study?

Are endovascular therapies for acute ischemic stroke safe and effective in patients older than 75 years compared to younger patients?

Population

2,254 patients with acute ischemic stroke, divided into an older cohort and a younger cohort

Comparison

Endovascular therapies for acute ischemic stroke vs Younger patients receiving endovascular therapies

Design

Cohort

Follow-up

12 months

Key result

Patients aged 75 years or older undergoing endovascular therapy for acute ischemic stroke had significantly higher rates of symptomatic intracranial hemorrhage (24% vs 9%) and in-hospital mortality (46% vs 26%) compared to younger patients.

Authors

NZNeer Zeevi GKGeorge A. Kuchel NLN.S. Lee

Discussion

Member takes

Overview

Caution advised for endovascular therapy in patients ≥75 years; leaves open optimal selection criteria for this population.

Study Design

Type

Cohort (n=2,254)

Multicenter

Structured PICO

Are endovascular therapies for acute ischemic stroke safe and effective in patients older than 75 years compared to younger patients?

Population

2,254 patients with acute ischemic stroke, of whom 107 received endovascular therapy, evaluated retrospectively to compare outcomes between patients aged ≥75 years and those <75 years.

Exposure

Endovascular therapies for acute ischemic stroke

Comparator

Younger patients (<75 years) receiving endovascular therapies

Outcome

Rates of endovascular treatment, symptomatic intracranial hemorrhage (SICH), in-hospital mortality, and modified Barthel Index (mBI) at 12 monthshard clinical

Main Result

Absolute Event Rate: 24% vs 9%

p-value: p=0.04

Endovascular therapies for acute ischemic stroke in patients ≥75 years are associated with higher rates of symptomatic intracranial hemorrhage, disability, and mortality compared to younger patients.

Limitations

Single-center retrospective analysis
Non-randomized treatment allocation leading to selection bias
Lack of perfusion imaging to guide patient selection
Did not distinguish between anterior and posterior circulation strokes or specific recanalization methods due to small sample size
Retrospective design

Cite This Study

Zeevi et al. (2011) conducted a cohort in Acute ischemic stroke (n=2,254). Age ≥75 years vs. Age <75 years was evaluated on Symptomatic intracranial hemorrhage (SICH) (p=0.04). Patients aged 75 years or older undergoing endovascular therapy for acute ischemic stroke had significantly higher rates of symptomatic intracranial hemorrhage (24% vs 9%) and in-hospital mortality (46% vs 26%) compared to younger patients.

synapsesocial.com/papers/6a221ffb4ae3d5108796f91b https://doi.org/10.3174/ajnr.a2845

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November 24, 2011American Journal of NeuroradiologyOpen Access

Interventional Stroke Therapies in the Elderly: Are We Helping?

View Full Paper

Ask AI

Bookmark

Why the study?

Are endovascular therapies for acute ischemic stroke safe and effective in patients older than 75 years compared to younger patients?

Population

2,254 patients with acute ischemic stroke, divided into an older cohort and a younger cohort

Comparison

Endovascular therapies for acute ischemic stroke vs Younger patients receiving endovascular therapies

Design

Cohort

Follow-up

12 months

Key result

Authors

NZNeer Zeevi GKGeorge A. Kuchel NLN.S. Lee

Discussion

Member takes

Overview

Caution advised for endovascular therapy in patients ≥75 years; leaves open optimal selection criteria for this population.

Study Design

Type

Cohort (n=2,254)

Multicenter

Structured PICO

Are endovascular therapies for acute ischemic stroke safe and effective in patients older than 75 years compared to younger patients?

Population

2,254 patients with acute ischemic stroke, of whom 107 received endovascular therapy, evaluated retrospectively to compare outcomes between patients aged ≥75 years and those <75 years.

Exposure

Endovascular therapies for acute ischemic stroke

Comparator

Younger patients (<75 years) receiving endovascular therapies

Outcome

Rates of endovascular treatment, symptomatic intracranial hemorrhage (SICH), in-hospital mortality, and modified Barthel Index (mBI) at 12 monthshard clinical

Main Result

Absolute Event Rate: 24% vs 9%

p-value: p=0.04

Limitations

Single-center retrospective analysis
Non-randomized treatment allocation leading to selection bias
Lack of perfusion imaging to guide patient selection
Did not distinguish between anterior and posterior circulation strokes or specific recanalization methods due to small sample size
Retrospective design

Cite This Study

synapsesocial.com/papers/6a221ffb4ae3d5108796f91b https://doi.org/10.3174/ajnr.a2845

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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