E-019 Mechanical thrombectomy for nonagenarian with M1 occlusion: analysis from multicenter cohort

Introduction Elderly individuals are at an increased risk for stroke and are responsible for a substantial portion of the total stroke burden. The safety and efficacy of thrombectomy in nonagenarians is not fully understood, as they have traditionally been excluded from major endovascular trials. Recent literature suggests 7% of patients have functional independence at 3 months following medical management. This research aims to determine the outcomes of thrombectomy in patients ≥ 90 years with proximal intracranial occlusion. Methods We performed a multicenter retrospective analysis of consecutive acute ischemic stroke patients with M1 occlusion treated within 24 hours from the time of last known well who were greater than 89 years of age. Patient demographics, periprocedural metrics, and discharge and 90-day modified Rankin Scale (mRS) scores were collected. Successful recanalization was defined as TICI 2B or better. Favorable outcome was defined as 90-day mRS≤2 for patients prestroke mRS 2. Results Seventy-one patients over 89 years old were identified. Fifty-two (73.2%) were female. Pre-stroke mRS scores were available for 70 patients. The baseline median mRS was 2. Successful recanalization was achieved in 95.8% of patients. TICI 2C or greater was accomplished in 64.8% of cases. Functional outcome data at 90-days were available for 57 patients (80.2%). At three months, 7 total patients had an mRS between 0–2 (12.3%), and an additional 11 patients had an mRS of 3 (19.2%). The rate of 90-day mortality was 42%. Conclusions Mechanical thrombectomy in nonagenarians is technically feasible with high rate of successful reperfusion and it may improve clinical outcome. More research is needed to determine if thrombectomy results in significantly better functional outcomes than medical management for nonagenarians. Disclosures S. Majidi: None. J. Vargas: 2; C; Cerenovus, Medtronic. 4; C; Truvic. J. Blalock: None. H. Hawk: None. S. Nimjee: None. A. Zakeri: None. M. Mokin: 2; C; Medtronic, Cerenovus. 4; C; Endostream, Serenity medical. R. Kellogg: None. G. Cortez: None. A. Aghaebrahim: None. E. Sauvageau: None. R. Hanel: 1; C; Stryker, Medtronic. 2; C; Stryker, Medtronic, Balt, Cerenovus, Microvention, Q’Apel, Rapid Medical. 4; C; Scientia, RisT, Corindus. R. DeLeacy: None. A. Siddiqui: 1; C; NIH-NINDS R21 NS109575-01. 2; C; Cerenovus, Imperitive Care, Medtronic, Microvention, Penumbra, Q’Apel. 4; C; Imperitive Care, Q’Apel, Rist, Truvic. A. Turk: 2; C; Imperitive Care, Stryker, Microvention, Penumbra, BALT, Cerenovus. 4; C; Imperitive Care. M. Oselkin: None. E. Marlin: None. R. Turner: 2; C; Q’apel, Cerenovus, Siemens. 4; C; Q’APel. I. Chaudry: 2; C; Cerenovus, Q’Apel. 4; C; Q’Apel. J. Milburn: None.