Mechanical Thrombectomy for Acute Ischemic Stroke in Octogenarians: A Systematic Review and Meta-Analysis

作者：Weisong Zhao, Pengju Ma, Ping Zhang, Xuejing Yue · 发表于：Frontiers in Neurology · 年份：2020 · DOI：10.3389/fneur.2019.01355 · 被引用次数：53 · 研究领域：Acute Ischemic Stroke Management、Stroke Rehabilitation and Recovery、Venous Thromboembolism Diagnosis and Management

Background and purpose: Multiple randomized trials have confirmed that mechanical thrombectomy (MT) is an effective treatment method for patients with acute ischemic stroke (AIS). However, evidence on the safety and efficacy of MT in elderly patients compared with younger patients is controversial. This meta-analysis is aimed to systematically compare the outcomes of elderly patients and younger patients after MT for AIS. Methods: A systematical literature search was conducted in the PubMed, EMBASE and Cochrane Library database. The primary outcomes were favorable functional outcome at 90 days and mortality. The secondary outcomes were symptomatic intracerebral hemorrhage (sICH) and successful recanalization rate. Odds ratios (ORs) was estimated using a random effects model. Results: Sixteen studies published between 2014 and 2019 were included in this meta-analysis totally involving 3952 patients. The pooled results showed that patients aged ≥80 years had worse functional outcome (OR=0.41; [95% CI, 0.32-0.51]; P<0.001), and higher rates of mortality (OR=2.26; [95% CI, 1.73-2.95]; P<0.001). There was a trend of higher rates of sICH in patients aged ≥80 years compared with patients aged <80 years, whereas this did not reach statistical significance (OR=1.29; [95% CI, 0.90-1.85]; P=0.17). Furthermore, the frequency of successful recanalization was also lower in patients aged ≥80 years compared with patients aged <80 years (OR=0.70; [95% CI, 0.54–0.92]; P<0.01). The subgroup ana...