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Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation.

Publication ,  Journal Article
Jayaraman, MV; Kishkovich, T; Baird, GL; Hemendinger, ML; Tung, EL; Yaghi, S; Cutting, S; Saad, A; Burton, TM; Mac Grory, B; Haas, RA ...
Published in: J Neurointerv Surg
February 2019

BACKGROUND: Older patients undergoing thrombectomy for emergent large vessel occlusion have worse outcomes. However, complete or near-complete reperfusion (modified Thrombolysis in Cerebral Ischemia (mTICI) score of 2 c/3) is associated with improved outcomes compared with partial recanalisation (mTICI 2b). OBJECTIVE: To examine the relationship between outcomes and age separately for the mTICI 2c/3, 2b and 0-2a groups in patients undergoing thrombectomy for anterior circulation emergent large vessel occlusion. METHODS: Retrospective review of 157 consecutive patients undergoing thrombectomy at a single centre with an occlusion of the internal carotid artery (ICA), M1 or proximal M2 segments of the middle cerebral artery (MCA). Angiograms were graded in a blinded fashion. Patients were divided into three groups: mTICI 0-2a, mTICI 2b, and mTICI 2c/3. Demographics and workflow parameters were compared. Outcomes at 90 days were compared as a function of age, using both the conventional modified Rankin scale (mRs) and utility weighted mRs (UWmRs). RESULTS: There were 72, 61 and 24 patients in the mTICI 2c/3, 2b and 0-2a groups, respectively. Outcomes were significantly worse with increasing age for the mTICI 2b group, but not for the mTICI 0-2a and 2c/3 groups (P=0.0002). With increasing age, outcomes of the mTICI 2b group approached those of the mTICI 0-2a group. However, outcomes of the mTICI 2c/3 groups were similar for all ages. This association was present for both the original mRs and UWmRs. CONCLUSION: Increasing age was associated with worse outcomes for those with partial (mTICI 2b) recanalisation, not in patients with complete (mTICI 2c/3) recanalisation.

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Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

February 2019

Volume

11

Issue

2

Start / End Page

114 / 118

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Middle Aged
  • Mechanical Thrombolysis
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Jayaraman, M. V., Kishkovich, T., Baird, G. L., Hemendinger, M. L., Tung, E. L., Yaghi, S., … McTaggart, R. A. (2019). Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation. J Neurointerv Surg, 11(2), 114–118. https://doi.org/10.1136/neurintsurg-2018-013964
Jayaraman, Mahesh V., Thomas Kishkovich, Grayson L. Baird, Morgan L. Hemendinger, Eric L. Tung, Shadi Yaghi, Shawna Cutting, et al. “Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation.J Neurointerv Surg 11, no. 2 (February 2019): 114–18. https://doi.org/10.1136/neurintsurg-2018-013964.
Jayaraman MV, Kishkovich T, Baird GL, Hemendinger ML, Tung EL, Yaghi S, et al. Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation. J Neurointerv Surg. 2019 Feb;11(2):114–8.
Jayaraman, Mahesh V., et al. “Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation.J Neurointerv Surg, vol. 11, no. 2, Feb. 2019, pp. 114–18. Pubmed, doi:10.1136/neurintsurg-2018-013964.
Jayaraman MV, Kishkovich T, Baird GL, Hemendinger ML, Tung EL, Yaghi S, Cutting S, Saad A, Burton TM, Mac Grory B, Haas RA, Furie KL, McTaggart RA. Association between age and outcomes following thrombectomy for anterior circulation emergent large vessel occlusion is determined by degree of recanalisation. J Neurointerv Surg. 2019 Feb;11(2):114–118.

Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

February 2019

Volume

11

Issue

2

Start / End Page

114 / 118

Location

England

Related Subject Headings

  • Treatment Outcome
  • Thrombectomy
  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Middle Aged
  • Mechanical Thrombolysis
  • Male
  • Humans
  • Female