Abstract W P7: Intra-Arterial Therapy is Safe and Effective in Patients Aged ≥80

Abstract

Introduction: Acute ischemic stroke (AIS) occurs most frequently in old age. Currently, conflicting evidence exists on the safety and efficacy of intra-arterial treatment (IAT) in the management of AIS in the elderly. We purported to compare the outcomes of patients ≥80 years receiving IAT after AIS to those of patients 55-79 years old. Methods: Data were retrospectively abstracted for consecutive AIS patients ≥55 years treated with IAT at an urban comprehensive stroke center between 2010 and 2013. The following outcomes were compared between patients 55-79 vs. ≥80 years following IAT: safety was assessed by incidence of sICH and in-hospital mortality; efficacy was examined using discharge mRS (favorable, ≤2) and improvement in NIHSS (decreased score at discharge). All analyses were performed with Pearson or Fisher’s exact chi-square tests. The subset of patients receiving IAT only was also examined. Results: IAT was performed in 300 patients, of which 241 were aged ≥55 and comprise our study cohort; of the 241, 104 received IAT only. There were no significant differences between the two age groups receiving IAT in race, presence of comorbidities and time to IAT while significant differences were observed for gender and NIHSS, with the ≥80 population presenting with lower mean stroke severity and more females (p <0.05 for both comparisons). Mortality and sICH rates were not significantly different following IAT between age groups, both in the overall cohort as well as the subset that received IAT only (table). Efficacy was similar between age groups in the overall cohort (table); in the subset that received IAT only, there was a trend towards a higher proportion of patients 55-79 years with improved NIHSS following treatment compared to those ≥80 years (p=0.07). Conclusion: These findings suggest that IAT is safe and effective in patients ≥80 years and age should not be used as a contraindication to IAT.