The Effectiveness of Intra-arterial Thrombolysis in Octogenarians after Acute Ischemic Stroke

, Sung Woong Woo; , Jae Hoon Kim; , Hee In Kang; , Deok Ryeong Kim; , Byung Gwan Moon; , Joo Seung Kim

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2015;11(2):204-208.
Published online September 30, 2015.

The Effectiveness of Intra-arterial Thrombolysis in Octogenarians after Acute Ischemic Stroke

Sung Woong Woo , Jae Hoon Kim , Hee In Kang , Deok Ryeong Kim , Byung Gwan Moon , Joo Seung Kim

Department of Neurosurgery, Eulji Hospital, Eulji University College of Medicine, Seoul, Korea

Abstract

Objective
This study aims to investigate the effectiveness of intra-arterial thrombolysis (IAT) in octogenarians after anterior circulation acute ischemic stroke (AIS).
Methods
We retrospectively analyzed 67 consecutive AIS patients treated by IAT between 2010 and 2014. We compared the IAT outcomes between ≥80 year old (n=17) and <80 year old (n=50) group. The degrees of vessel recanalization were evaluated by the Thrombolysis in Cerebral Infarction (TICI) grading system. The clinical outcomes were assessed using death and modified Ranking Scale (mRS) scores at three months.
Results
The mean age of patients was 72.1±11.3 years old. The mean National Institutes of Health Stroke Scale score was 17.1 in octogenarian group (OG) and 15.8 in younger group (YG). The successful recanalization rate (TICI grade 2-3) was 88% (15/17) in OG group and 78% (39/50) in YG group (p=0.296). Symptomatic hemorrhage more frequently occurred in OG(4/17) compared with YG group (2/50) (p=0.032). There were no significant differences in mortality and mRS score at 3 months between OG and YG(p=1.000 and 0.181, respectively).
Conclusion
The IAT in octogenarians was as effective for achieving successful recanalization and favorable clinical outcome as younger patients after AIS. However, careful strategy will be needed to minimize symptomatic hemorrhage in octogenarians.

Key Words: Acute ischemic strokeㆍIntra-arterial thrombolysisㆍOctogenarian