Discrepancy between early neurological course and mid-term outcome in older stroke patients after mechanical thrombectomy

Abstract

Older patients exhibit a similar early neurological course and responsiveness to mechanical thrombectomy as younger patients, but this is not reflected in mid-term functional outcome scores. This indicates that post-stroke complications and other factors that are not, or only indirectly, related to the brain tissue damage induced by the incident stroke have a dominant role in their poor prognosis.

Elevated mean platelet volume is associated with poor outcome after mechanical thrombectomy

“…Our findings are in agreement with the results in several studies of endovascular treatment with thrombolysis or MT 17 21 38. Older age is frequently related to poor outcome after endovascular treatment, probably owing to several factors including pre-stroke cognitive or physical impairments, reduced neuronal plasticity, a higher rate of postoperative complications and comorbidities 18 21. Our analysis also showed that successful revascularization was an independent predictor of good outcome, being consistent with previous studies 21 38.…”

Time to redefine success? TICI 3 versus TICI 2b recanalization in middle cerebral artery occlusion treated with thrombectomy

“…NIHSS scores and, in particular, early NIHSS scores, have been shown to provide greater statistical power than disability scales such as the mRS or the Barthel Index to ascertain benefits of acute stroke therapies, making them particularly suitable for the purpose of our study 16 17. Mid-term mRS scores, in contrast, are more prone to be confounded by comorbidities and post-stroke complications, particularly in older patients,23 who comprised a substantial proportion of our sample (32.3%, n=85) owing to the liberal eligibility criteria for MTE in our institution, which do not include an age limit.…”

Thrombus Migration in the Middle Cerebral Artery: Incidence, Imaging Signs, and Impact on Success of Endovascular Thrombectomy

“…The NIHSS, however, is a dedicated scoring system more directly reflecting the multifaceted and complex neurologic damage caused by ischemic lesions . Further, short‐term NIHSS scores have been shown to be a sensitive outcome measure in detecting small treatment effects and are less prone to confounding effects such as age and comborbidities . This particularly holds true because our institution did not apply an age limit, and thus, a considerable portion of octo‐ and nonagenarians were included (n=103).…”