Elderly patients and intra-arterial stroke therapy

Expert Rev Cardiovasc Ther. 2013 Dec;11(12):1713-23. doi: 10.1586/14779072.2013.839219. Epub 2013 Nov 7.

Abstract

Ischemic stroke disproportionately affects the elderly, particularly those over the age of 80 years. Rates of stroke are expected to increase over the next several decades due to increasing numbers of elderly individuals, making understanding stroke treatment in this population an imperative. The only proven acute stroke therapy is early reperfusion, accomplished through intravenous or intra-arterial means. Intra-arterial stroke therapy (IAT) offers higher recanalization rates than intravenous tissue plasminogen activator, but has yet to show clear superiority over intravenous tissue plasminogen activator alone. Existing data suggest that elderly stroke patients suffer worse outcomes following IAT, despite similar rates of recanalization and symptomatic intracranial hemorrhage. This article reviews the application of IAT in the elderly population and summarizes the available studies that investigate the response of elderly patients to IAT.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / epidemiology
  • Brain Ischemia / pathology
  • Brain Ischemia / therapy*
  • Humans
  • Intracranial Hemorrhages / epidemiology
  • Intracranial Hemorrhages / etiology
  • Stroke / epidemiology
  • Stroke / pathology
  • Stroke / therapy*
  • Thrombolytic Therapy / methods*
  • Tissue Plasminogen Activator / administration & dosage
  • Tissue Plasminogen Activator / therapeutic use
  • Treatment Outcome

Substances

  • Tissue Plasminogen Activator