Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age
The effectiveness of endovascular therapy for patients aged 90 years and over (90 years) is still not well understood. We compared the patients aged 90 years with those aged 85-89 years, 80-84 years, and <80 years using data from the Japanese Registry of NeuroEndovascular Therapy that enrolled ac...
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The Japan Neurosurgical Society
2025-04-01
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| Series: | Neurologia Medico-Chirurgica |
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| Online Access: | https://www.jstage.jst.go.jp/article/nmc/65/4/65_2024-0232/_pdf/-char/en |
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| author | Fuminori SHIMIZU Kazutaka UCHIDA Hiroto KAKITA Sou SAWAMURA Akihiro KANBARA Yuji KITADA Yoshinori AKIYAMA Takashi YOSHIDA Satoru FUJIWARA Hirotoshi IMAMURA Chiaki SAKAI Manabu SHIRAKAWA Shinichi YOSHIMURA Nobuyuki SAKAI the JR-NET4 Study Group |
| author_facet | Fuminori SHIMIZU Kazutaka UCHIDA Hiroto KAKITA Sou SAWAMURA Akihiro KANBARA Yuji KITADA Yoshinori AKIYAMA Takashi YOSHIDA Satoru FUJIWARA Hirotoshi IMAMURA Chiaki SAKAI Manabu SHIRAKAWA Shinichi YOSHIMURA Nobuyuki SAKAI the JR-NET4 Study Group |
| author_sort | Fuminori SHIMIZU |
| collection | DOAJ |
| description | The effectiveness of endovascular therapy for patients aged 90 years and over (90 years) is still not well understood. We compared the patients aged 90 years with those aged 85-89 years, 80-84 years, and <80 years using data from the Japanese Registry of NeuroEndovascular Therapy that enrolled acute large vessel occlusion patients from January 2015 to December 2019. The primary outcome was the rate of return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days. Secondary outcomes were the incidences of intracranial hemorrhage and mortality. Among 13,540 patients, patients aged 90 years, 85-89 years, 80-84 years, and <80 years were 1,104, 1,925, 2,477, and 8,034. The prevalence of female gender, the premorbid Rankin Scale, and the National Institutes of Health Stroke Scale score before endovascular therapy were highest in the patients aged 90 years (n [%], 819 [74.2]; median [interquartile range]; 2 [0-3], and 21 [15-26]). The primary outcome of the adjusted odds ratio (95% confidence intervals) for the patients aged 85-89 years, 80-84 years, and <80 years for 90 years was 0.89 (0.72-1.10), 0.95 (0.77-1.16) and 1.07 (0.89-1.28). However, the incidence of symptomatic intracranial hemorrhage was lower in patients aged 90 years compared with patients aged 85-89 years and <80 years (adjusted odds ratio [95% confidence intervals]; 1.86 [1.16-2.98] and 1.71 [1.11-2.64]). The return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days in patients aged 90 years with large vessel occlusion was not significantly different in other groups but symptomatic intracranial hemorrhage was less observed than in younger patients. |
| format | Article |
| id | doaj-art-8b058b2059c34fc89e3e0cf554e5bea1 |
| institution | DOAJ |
| issn | 1349-8029 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | The Japan Neurosurgical Society |
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| series | Neurologia Medico-Chirurgica |
| spelling | doaj-art-8b058b2059c34fc89e3e0cf554e5bea12025-08-20T02:56:09ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292025-04-0165418619410.2176/jns-nmc.2024-02322024-0232Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of AgeFuminori SHIMIZU0Kazutaka UCHIDA1Hiroto KAKITA2Sou SAWAMURA3Akihiro KANBARA4Yuji KITADA5Yoshinori AKIYAMA6Takashi YOSHIDA7Satoru FUJIWARA8Hirotoshi IMAMURA9Chiaki SAKAI10Manabu SHIRAKAWA11Shinichi YOSHIMURA12Nobuyuki SAKAI13the JR-NET4 Study GroupDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurosurgery, Shimizu HospitalDepartment of Neurology, Kobe City Medical Center General HospitalDepartment of Neurosurgery, National Cerebral and Cardiovascular CenterDepartment of Neurosurgery, Kyoto University Graduate School of MedicineDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Hyogo Medical UniversityDepartment of Neurosurgery, Shimizu HospitalThe effectiveness of endovascular therapy for patients aged 90 years and over (90 years) is still not well understood. We compared the patients aged 90 years with those aged 85-89 years, 80-84 years, and <80 years using data from the Japanese Registry of NeuroEndovascular Therapy that enrolled acute large vessel occlusion patients from January 2015 to December 2019. The primary outcome was the rate of return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days. Secondary outcomes were the incidences of intracranial hemorrhage and mortality. Among 13,540 patients, patients aged 90 years, 85-89 years, 80-84 years, and <80 years were 1,104, 1,925, 2,477, and 8,034. The prevalence of female gender, the premorbid Rankin Scale, and the National Institutes of Health Stroke Scale score before endovascular therapy were highest in the patients aged 90 years (n [%], 819 [74.2]; median [interquartile range]; 2 [0-3], and 21 [15-26]). The primary outcome of the adjusted odds ratio (95% confidence intervals) for the patients aged 85-89 years, 80-84 years, and <80 years for 90 years was 0.89 (0.72-1.10), 0.95 (0.77-1.16) and 1.07 (0.89-1.28). However, the incidence of symptomatic intracranial hemorrhage was lower in patients aged 90 years compared with patients aged 85-89 years and <80 years (adjusted odds ratio [95% confidence intervals]; 1.86 [1.16-2.98] and 1.71 [1.11-2.64]). The return of the modified Rankin Scale to at least the premorbid modified Rankin Scale after 30 days in patients aged 90 years with large vessel occlusion was not significantly different in other groups but symptomatic intracranial hemorrhage was less observed than in younger patients.https://www.jstage.jst.go.jp/article/nmc/65/4/65_2024-0232/_pdf/-char/envery elderly patientacute ischemic strokepremorbid modified rankin scaleintracranial hemorrhage |
| spellingShingle | Fuminori SHIMIZU Kazutaka UCHIDA Hiroto KAKITA Sou SAWAMURA Akihiro KANBARA Yuji KITADA Yoshinori AKIYAMA Takashi YOSHIDA Satoru FUJIWARA Hirotoshi IMAMURA Chiaki SAKAI Manabu SHIRAKAWA Shinichi YOSHIMURA Nobuyuki SAKAI the JR-NET4 Study Group Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age Neurologia Medico-Chirurgica very elderly patient acute ischemic stroke premorbid modified rankin scale intracranial hemorrhage |
| title | Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age |
| title_full | Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age |
| title_fullStr | Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age |
| title_full_unstemmed | Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age |
| title_short | Outcome after Endovascular Treatment of Patients with Acute Ischemic Stroke with Large Vessel Occlusion over 90 Years of Age |
| title_sort | outcome after endovascular treatment of patients with acute ischemic stroke with large vessel occlusion over 90 years of age |
| topic | very elderly patient acute ischemic stroke premorbid modified rankin scale intracranial hemorrhage |
| url | https://www.jstage.jst.go.jp/article/nmc/65/4/65_2024-0232/_pdf/-char/en |
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