77 - Comparing Outcomes of Endovascular Thrombectomy for Large Vessel Occlusion Strokes in Patients Aged 80-89 vs. 90+

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Hamsat Anwar (she/her/hers)

Medical Student
Western University of Health Sciences COMP-NW, United States

Author/Co-author(s)

HM

Horia Marginean, MD, MS

Clinical Research Scientist Biostatistics
Providence Brain and Spine Institution, United States
AL

Alexandra Lesko, BS

Program Research Manager & Student Research Coordinator
Providence Brain and Spine Institute, United States
VD

Vivek Deshmukh, MD

Director, Cerebrovascular Neurosurgery Providence Brain and Spine Institute
Providence Brain and Spine Institute and The Oregon Clinic, United States

Purpose: Research on endovascular thrombectomy (EVT) outcomes in patients with acute ischemic strokes due to large vessel occlusions often underrepresents elderly individuals. This study describes the outcomes of EVT in patients ≥ 80 years of age.

Materials and Methods: Retrospective data for patients ≥80 years discharged between October 2018-August 2023 with primary diagnosis of ischemic stroke were collected from the electronic medical records from two Oregon medical centers. EVT treated patients with a large vessel occlusion (LVO) in 1 or more locations of: ICA, M1, M2, M3, ACA, basilar or vertebral artery were included. Patients with inpatient strokes were excluded. The primary outcomes: TICI scores (Good = 2b/3), discharge disposition (DD), admission to discharge change in NIHSS, percent mortality and 90D mRS return to baseline. Outcomes were analyzed using generalized linear models.

Results: Out of 144 patients, 67% female, 75% white. The median age was 96 (82, 89). Median LKW to arrival was 3.3 (0.9, 8) hours with 31% ≥ 6hrs after LWK. Post-treatment TICI score was 2b/3 for 59% patients. Pre-stroke mRS was 0-2 for 79% whereas only 10% at 90D with 5% returned to baseline. Median NIHSS at admission was 18 (13, 24). Median change in NIHSS was 8 (3, 15). Eighty-four percent had a good DD. The 90D mortality was 42%. Increased age at arrival had a decrease in 90D mRS 0-2 (OR 0.74, 95%CI 0.60-0.88, p < 0.001), and increased 90D mortality rate (OR 1.1, 95%CI 1.0-1.2, p = .03). Increased age at arrival has marginally significant association with poor DD (OR 0.91, 95%CI 0.82-1.00, p = .07).

Conclusion: Our population primarily consisting of patients with moderate acute ischemic LVO stroke and minimal baseline disability, no significant differences were observed in post-revascularization outcomes between the 80-89 year old group and the 90 years and above group, including TICI scores, median change of NIHSS, 90D mRS return to baseline, DD, or 90D mortality.