Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Original Article
Clinical Results of Mechanical Thrombectomy in Nonagenarians with Acute Ischemic Stroke
Yuichiro TsujiTakanori MikiHiroto KakitaKimitoshi SatoTakashi YoshidaFuminori Shimizu
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2020 Volume 14 Issue 8 Pages 295-300


Objective: Multiple randomized trials have demonstrated the efficacy of mechanical thrombectomy (MT), but very elderly patients aged ≥90 years were excluded. It remains uncertain whether endovascular therapy is effective for nonagenarians. The objective of this study was to investigate the effectiveness and safety of MT in nonagenarians.

Methods: Between January 2016 and March 2019, acute ischemic stroke patients aged ≥80 years who underwent MT at our hospital were retrospectively reviewed. Patients with a baseline pre-stroke modified Rankin Scale (mRS) score ≥3 were excluded from the analysis. They were divided into octogenarians (80–89 years old) and nonagenarians (90–99 years old).

Results: Forty-five patients met the inclusion criteria, including 34 octogenarians and 11 nonagenarians. Nonagenarians were more likely to be female (47.0% vs 90.9%; p <0.05). There was a significantly lower rate of a pre-stroke mRS score of 0–1 among the nonagenarians (91.1% vs 63.6%; p <0.05). Revascularization was successful in 71.0% and 81.8% (p = 0.46) of octogenarians and nonagenarians, respectively. Functional independence (mRS ≤2) at discharge was observed in 26.4% vs 27.2% (p = 0.95) of octogenarians and nonagenarians, respectively.

Conclusion: MT in nonagenarians can be considered safe without increasing hemorrhagic complications in comparison with that in octogenarians. One in four patients may have a good outcome and obtain effects equivalent to those in octogenarians if they have a good pre-stroke functional status.

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© 2020 The Japanese Society for Neuroendovascular Therapy

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