You are here

Article Text

Article menu
Download PDFPDF
Ischemic stroke
Mechanical thrombectomy for treatment of acute ischemic stroke in frail patients: a systematic review of the literature
  1. Nisha Dabhi,
  2. Jeyan Kumar,
  3. Ryan T Kellogg,
  4. Min S Park
  1. Department of Neurosurgery, Univerisity of Virginia, Charlottesville, Virginia, USA
  1. Correspondence to Dr Min S Park; MP2TQ{at}uvahealth.org

Abstract

Background The overall safety and efficacy of mechanical thrombectomy (MT) for acute ischemic stroke (AIS) in frail patients is not well delineated. This systematic review aims to summarize and compare outcomes in frail and non-frail patients who underwent MT for AIS.

Methods A systematic review of the literature was performed using PubMed, Ovid Medline, and Web of Science to identify studies with outcomes-related data for frail patients with MT-treated AIS. The recanalization rate, procedural complications, and clinical outcome at 90-day follow-up were collected.

Results In the four included studies there were 642 frail patients and 499 non-frail patients. Frail patients had reduced rates of good functional outcomes (29% vs 42%; χ2=22, p<0.01) and increased 90-day mortality (51% vs 25%; χ2=38, p<0.01) compared with non-frail patients.

Conclusion MT for treatment of AIS in frail patients may be associated with worse rates of morbidity and mortality along with reduced efficacy. Given that no studies to date directly compare conservative measures with endovascular management for AIS in frail patients, more studies are required to further evaluate and identify characteristics that may improve outcomes in these patients.

  • Stroke
  • Thrombectomy

Data availability statement

No data are available.

https://doi.org/10.1136/jnis-2023-020476

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    No data are available.

    View Full Text

    Footnotes

    • Contributors MSP and RTK conceived the idea for the manuscript. MSP served as the guarantor. ND and JK were involved in conducting the systematic review, creating tables and figures, and analyzing data. ND, JK, MSP, and RTK were all major contributors to writing and editing the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.