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Letter to the Editor
Efficacy of intra-arterial therapy in the elderly requires further study
  1. Joshua A Hirsch,
  2. Brijesh P Mehta,
  3. Ronil V Chandra,
  4. Thabele M Leslie-Mazwi,
  5. Natalia S Rost,
  6. Albert J Yoo
  1. Department of NeuroInterventional Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr J A Hirsch, Department of NeuroInterventional Radiology, Massachusetts General Hospital, 55 Fruit Street, Gray 2, Boston, MA 02114, USA; hirsch{at}snisonline.org

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We salute Dr Ghobrial and colleagues for their important contribution regarding the endovascular management of elderly ischemic stroke patients.1 Although this topic is relatively new to the literature, it is of critical importance to the field of intra-arterial therapy (IAT), given the increasing use of catheter based stroke therapies2 and the expanding population of elderly Americans who are at the highest risk for ischemic stroke.

The authors conducted an extensive, retrospective, single center study using chart review that identified elderly patients (aged >75 years) that underwent IAT between 2006 and 2012. The minimum National Institutes of Health Stroke Scale score used in this analysis was 8, and patients were selected using non-contrast between 2006 and 2009, and from 2009 onwards, additional CT angiography and CT perfusion studies were performed. The recanalization rate (TIMI 2–3) was 65%, with symptomatic intracranial hemorrhage occurring in 6%. All cause mortality was 22%, with two deaths from intraoperative vessel rupture. The average discharge modified Rankin Scale …

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