Abstract
Background and purpose: The usefulness of endovascular thrombectomy for acute ischemic stroke has recently been shown in several randomized control trials. We retrospectively analyzed the efficacy of actions to reduce revascularization and treatment times in elderly patients and assessed the difference in treatment times and recanalization rates using different devices.
Object and methods: We reviewed the clinical records of 64 consecutive patients who underwent endovascular thrombectomy for acute ischemic stroke between July 2014 and February 2016. We adopted various approaches to reduce the time to recanalization.
Results: A total of 54 cases (85%) had a thrombolysis in cerebral infarction (TICI) score exceeding 2B. The number of cases with a favorable modified Rankin Scale (mRS) score of 0-2 at discharge was 23 (36%), and there were 6 (9%) deaths. We significantly reduced the arrival to puncture time by approximately 40 minutes, from 113.7 to 74.2 minutes, and the prognosis tended to improve. The puncture to recanalization time was the shortest in the stent retriever alone group, and the rate of TICI 3 was high in this group.
Conclusions: Adopting various approaches to reduce the recanalization time is important for improving patient prognosis. The prognosis in elderly patients tends to be poor; however, the optimal treatment regimen should not be selected according to age because some elderly cases demonstrated a favorable outcome.
The present findings suggest that the use of a stent retriever should be the first choice of treatment for such patients.
