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KMID : 1150320160120020191
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Journal of Korean Society of Geriatric Neurosurgery
2016 Volume.12 No. 2 p.191 ~ p.197
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The Outcome of Endovascular Revascularization in Patient Aged Older than 65 Years for an Acute Internal Carotid Artery Occlusion
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Kim Jin-Seong
Shin Hee-Sup
Lee Seung-Hwan
Ko Hak-Cheol
Koh Jun-Seok
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Abstract
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Objective: Acute occlusion of an internal carotid artery (ICA) is known to have low recanalization rate and poor outcome. And as the elderly population increases, the number of acute ICA occlusion increases in proportion to their growth. Thus, we compared the outcomes in patients aged older than 65 years of age with the outcomes in a matched group of younger patients who received endovascular revascularization for an acute ICA occlusion.
Methods: Twenty-eight consecutive patients who underwent endovascular treatment for acute ICA occlusion were identified. We reviewed the clinical and radiological data, and assessed initial clinical status (NIHSS), stroke risk factors, endovascular procedure, recanalization result (TICI), and outcome (mRS).
Results: Stent retrievers were applied to all patients as first-line manner. Penumbra system (n=4) and balloon angioplasty (n=2) were conducted additionally, if needed. Successful recanalization (TICI≥2) was obtained in 24 (85.7%) patients and good outcome (mRS≤2) in 12 (42.8%) patients. Good clinical outcome was related to short onset-torecanalization time (p=0.045) and the balloon guiding catheter (BGC, p=0.002). Good recanalization tend to influence the outcome (p=0.061), and the BGC also tend to shorten the procedure time (p=0.088).
Conclusion: The initial NIHSS, revascularization time, and the use of BGC are favorable factors even in elderly patients. Although the final outcomes are lower than younger patients, the successful rate of endovascular revascularization for acute ICA occlusion in elderly patients is comparable to that of younger patients.
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KEYWORD
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Acute ICA occlusion, Stent retrievers, Endovascular revascularization, Clinical outcome
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