2018 年 12 巻 9 号 p. 423-430
Objective: We retrospectively compared the results of treatment between patients aged ≥85 years and those aged <85 years among those who underwent thrombectomy for acute cerebral infarction in our hospital.
Methods: Of patients with acute cerebral infarction who underwent thrombectomy in our hospital between October 2014 and September 2017, the subjects were those with an interval of ≤8 hours from onset until arrival, a diffusion-weighted imaging-alberta stroke program early CT score (DWI-ASPECTS) of ≥6, and occlusion of the internal carotid (IC) artery, middle cerebral artery M1/M2, basilar artery (BA), or posterior cerebral artery P1.
Results: The subjects consisted of 12 patients aged ≥85 years and 27 aged <85 years, with mean ages of 88.5 and 72.3 years, respectively. The rate of patients who had taken antithrombotic drugs before onset was significantly higher in the latter. There were no significant differences in the diagnosis, risk factors, modified Rankin Scale (mRS) score before onset, National Institute of Health Stroke Scale (NIHSS) score on arrival, DWI-ASPECTS, or site of occlusion. Concerning treatment results, the mRS score on discharge was significantly higher in those aged ≥85 years, but there were no significant differences in the recanalization rate or incidence of hemorrhagic complications between the two groups.
Conclusion: In those aged ≥85 years, the mRS score on discharge was significantly higher. However, the recanalization rate was relatively high, and an improvement in the NIHSS score was achieved. Although the indication of thrombectomy should not be restricted based on the age alone, acute cerebral infarction patients aged ≥85 years must be accumulated to evaluate whether the procedure should be indicated.