Age ≥ 80 Years Is Not a Contraindication for Intra-Arterial Therapy after Ischemic Stroke

Background: Clinical trials confirmed the safety and efficacy of intra-arterial therapy (IAT) in the management of ischemic stroke. At a community hospital, we compared outcomes in patients aged >= 80 and patients in the age range 55-79 years receiving IAT following ischemic stroke. Methods: Data were retrospectively abstracted for ischemic stroke patients >= 55 years treated with IAT at an urban comprehensive stroke center between 2010 and 2013. Baseline demographics, incidence of symptomatic intracranial hemorrhage (sICH), inhospital mortality, discharge modified Rankin scale (mRS) score (favorable <= 2) and improvement in National Institutes of Health Stroke Scale Score (NIHSS; decreased score at discharge) were compared between patients in the age range 55-79 and patients >= 80 years. Data were analyzed using univariate analyses and multivariate logistic regression. Results: IAT was performed in 239 patients with ischemic stroke; 63 (26.4%) were >= 80 years. When compared to patients aged 55-79, the elderly patients were more often female and nonsmokers, with a history of atrial fibrillation. No differences were observed in those >= 80 years compared to patients in the age range 55-79 years for sICH (10 vs. 5%, p = 0.23), mortality (24 vs. 18%, p = 0.28), favorable discharge mRS score (13 vs. 19%, p = 0.27), or improvement in NIHSS (83 vs. 92%, p = 0.10). The nonsignificant association of age with the outcomes persisted after adjusting for covariates and when analyzing the subset of patients who received IAT only. Conclusions: These findings suggest that in a cohort not subject to the criteria of a clinical trial, age >= 80 years should not be a contraindication to IAT. (C) 2015 S. Karger AG, Basel