Prognostic Determinants of Anterior Large Vessel Occlusion in Acute Stroke in Elderly Patients

Abstract

This study investigated prognostic factors in elderly patients (80 years and older) undergoing mechanical thrombectomy (MT) for anterior circulation large vessel occlusion (LVO) in acute stroke treatment. Of 59 cases, 47.5% achieved a favorable outcome (mRS ≤ 3) at three months, with a mortality rate of 20.3%. Factors associated with better outcomes included younger age, lower admission National Institute of Health Stroke Scale (NIHSS) scores, lower N-terminal pro-brain natriuretic peptide (NT-proBNP) and D-dimer levels, the presence of the first pass effect (FPE), and successful recanalization. However, logistic regression showed that only lower admission NIHSS scores were significantly correlated with favorable outcomes. In addition, this study suggests that lower admission NT-proBNP and D-dimer levels could potentially serve as prognostic indicators for elderly LVO patients undergoing MT.

Diffusion MRI Fiber Tractography and Benzodiazepine SPECT Imaging for Assessing Neural Damage to the Language Centers in an Elderly Patient after Successful Reperfusion Therapy

“…cerebral microbleeds, higher systolic blood pressure or serum glucose level on admission, a higher National Institutes of Health Stroke Scale (NIHSS) score, the location of the occluded vessel, and procedure time intervals [3][4][5][6][7]. Furthermore, futile reperfusion is also associated with increased incidences of symptomatic intracranial hemorrhage and 90-day mortality [8].…”

“…However, approximately half of patients do not achieve meaningful long-term functional improvement, despite technically successful recanalization of the occluded artery and reperfusion of the ischemic territory. Several epidemiological studies have proposed the concept of “futile reperfusion” and its association with many prognostic risk factors, including older age, female sex, a medical history of hypertension or diabetes, presence of cerebral microbleeds, higher systolic blood pressure or serum glucose level on admission, a higher National Institutes of Health Stroke Scale (NIHSS) score, the location of the occluded vessel, and procedure time intervals [ 3 , 4 , 5 , 6 , 7 ]. Furthermore, futile reperfusion is also associated with increased incidences of symptomatic intracranial hemorrhage and 90-day mortality [ 8 ].…”