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  • O-025 Influence of Age and Gender on Clinical and Revascularisation Outcomes in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry

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O-025 Influence of Age and Gender on Clinical and Revascularisation Outcomes in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry
  1. A Castonguay1,
  2. R Gupta2,
  3. R Nogueira2,
  4. C Martin3,
  5. W Holloway3,
  6. N Mueller-Kronast4,
  7. T Malisch5,
  8. F Marden5,
  9. H Bozorgchami6,
  10. A Xavier7,
  11. T Rai8,
  12. A Badruddin9,
  13. M Taqi10,
  14. I Linfante11,
  15. G Dabus11,
  16. M Abraham12,
  17. H Shaltoni13,
  18. V Janardhan14,
  19. T Nguyen15,
  20. A Abou-Chebl16,
  21. P Chen17,
  22. A Yoo18,
  23. G Britz19,
  24. A Nanda20,
  25. O Zaidat1
  1. 1Medical College of Wisconsin, Milwaukee, WI
  2. 2Emory University School of Medicine, Atlanta, GA
  3. 3St. Luke's Kansas City, Kansas City, MO
  4. 4Delray Medical Center, Delray Beach, FL
  5. 5Alexian Brothers Medical Center, Elk Grove Village, IL
  6. 6Oregon Health and Sciences, Portland, OR
  7. 7Wayne State University School of Medicine, Detroit, MI
  8. 8West Virginia University Hospital, Morgantown, WV
  9. 9Provena St. Joseph Medical Center, Joliet, IL
  10. 10Desert Regional Medical Center, Palm Springs, CA
  11. 11Baptist Cardiac and Vascular Institute, Miami, FL
  12. 12University of Kansas Medical Center, Kansas City, KS
  13. 13Baylor College of Medicine, Houston, TX
  14. 14Texas Stroke Institute, Plano, TX
  15. 15Boston Medical Center, Boston, MA
  16. 16University of Louisville Medical School, Louisville, KY
  17. 17The University of Texas Medical School at Houston, Houston, TX
  18. 18Massachusetts General Hospital, Boston, MA
  19. 19Duke University Medical Center, Raleigh, NC
  20. 20University of Missouri, Columbia, MO

Abstract

Introduction/Purpose The recent results of the SWIFT and TREVO-2 trials demonstrated better recanalisation and efficacy rates with mechanical thrombectomy; however, its efficacy in the elderly population is poorly understood. Here, we report the effect of age on clinical and angiographic outcome within the North American SOLITAIRE-FR Stent-Retriever Acute Stroke (NASA) Registry.

Methods The investigator-initiated NASA Registry recruited sites within North America to submit data on consecutive patients treated with Solitaire-FR. Good clinical outcome was defined as a 90-day mRS ≤2. Successful recanalisation was defined as TIMI ≥2. SICH was defined as any parenchymal haematoma, SAH, or IVH associated with a worsening of the NIHSS score by 4 or more within 24 hours. Age influence on outcomes was assessed by comparing the means between outcomes and dichotomising the age into ≤80 or ≥80 years of age. A standard medical care cohort was not available for comparison in this study.

Results 343 patients underwent treatment using the SOLITAIRE-FR device in 24 centres. The mean age for those with good clinical outcome at 90 days was 64.9 ± 15 versus 69.2 ± 14.4 years (P=0.02). Only 26.6% (17/64) of patients >80 years of age had a 90-day mRS ≤ 2 versus 45.3% (111/245) of those ≤80 years of age (p=0.007, OR 1.34, 95%CI 1.2-1.6). Mortality was 42.2% (27/64) and 27.4% (67/245) in the >80 and ≤80 age groups, respectively. No difference in good outcome or mortality between female and males was observed in this population (90-day mRS≤ 2 was 41.3% (62/150) with mortality of 28% (42/150) versus 42.1% (69/164) with mortality of 32.3% (53/164) in females and males, respectively). Multivariate logistic regression analysis (adjusting for age, sex, race, baseline-NIHSS, occlusion site, initial BP, time from symptoms onset to groin puncture, and revascularisation), showed age, baseline-NIHSS, initial systolic blood pressure and revascularisation status as an independent predictors of both good outcome and mortality.

View this table:
Abstract O-025 Table 1

Conclusions In the NASA registry, patients >80 years of age who were treated with the Solitaire-FR device demonstrated a significantly lower rate of good clinical outcome and increased mortality at 90-days, compared to the those in the ≤ 80 years of age group.

Disclosures A. Castonguay: None. R. Gupta: None. R. Nogueira: None. C. Martin: None. W. Holloway: None. N. Mueller-Kronast: None. T. Malisch: None. F. Marden: None. H. Bozorgchami: None. A. Xavier: None. A. Rai: None. A. Badruddin: None. M. Taqi: None. I. Linfante: None. G. Dabus: None. M. Abraham: None. H. Shaltoni: None. V. Janardhan: None. T. Nguyen: None. A. Abou-Chebl: None. P. Chen: None. A. Yoo: None. G. Britz: None. A. Nanda: None. O. Zaidat: None.

http://dx.doi.org/10.1136/neurintsurg-2013-010870.25

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