Evaluation of safety andefficacy of intra-arterial thrombolysis for acute stroke in gerontal patients: atwo-center study

Abstract

：Objective To evaluatethe feasibility, safety and efficacy of intra-arterial thrombolytic therapy on elderlypatients (≥ 80 yearsold) with acute ischemic stroke. Methods The clinical data of 86 patients with acuteischemic stroke, received intra-arterial thrombolytic therapy, were retrospectivelyanalyzed; according to age differences, these patients were divided into advanced agegroup (≥80 years old,n=21) and common age group (<80 years old, n=65); and control group (≥80 years old, not receivingthrombolytic therapy, n=50) was established. The recanalization rate and early clinicalimprovement rate, and the incidence, recover rate and death rate of symptomaticintracerebral hemorrhage were evaluated in these patients after treatment. Results Nosignificant differences in the favorite recanalization rate and short-term outcome, andthe incidence of symptom intracranial hemorrhage were noted between the advanced age groupand common age group (P=0.528, P=0.102,P=0.353). The incidence of symptom intracranialhemorrhage in the advanced age group was obviously higher than that in the control group(P=0.034); the recover rate of symptom ntracranial hemorrhage in the advanced age group(42.9%) was obviously lower than that in the common age group (50.8%), but significantlyhigher than that in the control group (16%, P=0.042, P=0.017). The mortality of theadvanced age group was similar to that of the control group (23.8% versus 28%, P=0.816),but higher than that of common age group (23.8% versus 10.8%, P=0.034). ConclusionRelatively high feasibility, safety and efficacy of intra-arterial thrombolytic therapyare noted in elderly patients (≥80 years old) with acute ischemic stroke, demonstrating that theuse of intra-arterial thrombolytic therapy in very elderly patients should not be avoidedbut pursued advisably. Key words: Intra-arterial thrombolysis; Acute cerebral infarct; Elderly