O-025 Influence of Age and Gender on Clinical and Revascularisation Outcomes in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry
Authors: Castonguay A , Gupta R , Nogueira R , Martin C , Holloway W , Mueller-Kronast N , Malisch T , Marden F , Bozorgchami H , Xavier A , Rai T , Badruddin A , Taqi M , Linfante I , Dabus G , Abraham M , Shaltoni H , Janardhan V , Nguyen T , Abou-Chebl A , Chen P , Yoo A , Britz G , Nanda A , Zaidat O 
Published: July 2013

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.

Abstract O-025 Table 1VariableAge >80Age ≤ 80P-value/OR/95%CI90-day mRS ≤ 226.6% (17/64)45.3% (111/245)0.007 (1.34, 1.2-1.6)TICI ≥ 2a87.7% (64/73)87% (235/270)1/1 (0.5-2.3)Symptomatic ICH13.7% (10/73)9% (24/268)0.3/1.5 (0.8-3.1)Death42.2% (27/64)27.4% (67/245)0.03/RR1.54 (1.1-2.2)TOG: Mean (SD) in min368 (279.1)368.4 (229.7)0.5NIHSS-baseline: Mean (SD)19.1 (5.8)18 (6.8)0.9Number of Passes: Mean (SD)1.9 (1)1.9 (1.1)0.6

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.