| The Outcome of Endovascular Revascularization in Patient Aged Older than 65 Years for an Acute Internal Carotid Artery Occlusion |
|
Jin Seong Kim , Hee Sup Shin , Seung Hwan Lee , Hak Cheol Ko , Jun Seok Koh |
|
Department of Neurosurgery, Stroke and Neurological Disorder Centre, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea |
| 65세 이상의 환자에게서 급성 내경동맥 폐색에 대한 혈관 내 재관류의 결과 |
|
김진성·신희섭·이승환·고학철·고준석 |
|
강동경희대학교병원 경희대학교 의과대학 신경외과학교실 |
|
|
| Abstract |
Objective
Acute occlusion of an internal carotid artery (ICA) is known to have low recanalization rate and poor outcome. And as the elderly population increases, the number of acute ICA occlusion increases in proportion to their growth. Thus, we compared the outcomes in patients aged older than 65 years of age with the outcomes in a matched group of younger patients who received endovascular revascularization for an acute ICA occlusion.
Methods
Twenty-eight consecutive patients who underwent endovascular treatment for acute ICA occlusion were identified. We reviewed the clinical and radiological data, and assessed initial clinical status (NIHSS), stroke risk factors, endovascular procedure, recanalization result (TICI), and outcome (mRS).
Results
Stent retrievers were applied to all patients as first-line manner. Penumbra system (n=4) and balloon angioplasty (n=2) were conducted additionally, if needed. Successful recanalization (TICI≥2) was obtained in 24 (85.7%) patients and good outcome (mRS≤2) in 12 (42.8%) patients. Good clinical outcome was related to short onset-torecanalization time (p=0.045) and the balloon guiding catheter (BGC, p=0.002). Good recanalization tend to influence the outcome (p=0.061), and the BGC also tend to shorten the procedure time (p=0.088).
Conclusion
The initial NIHSS, revascularization time, and the use of BGC are favorable factors even in elderly patients. Although the final outcomes are lower than younger patients, the successful rate of endovascular revascularization for acute ICA occlusion in elderly patients is comparable to that of younger patients. |
| Key Words:
Acute ICA occlusion, Stent retrievers, Endovascular revascularization, Clinical outcome |
|
PDF Links
Download Citation
