Stroke Thrombectomy in the Elderly: Efficacy, Safety, and Special Considerations

Abstract

Background Elderly patients account for a major Q2 proportion of ischemic strokes worldwide, and the use of endovascular thrombectomy (EVT) for the elderly has been increasing in recent years. Major clinical trials have demonstrated the benefit of EVT for the general population; however, the degree of benefit is less clear in elderly populations. Although EVT is generally considered safe and effective in healthy elderly adults, there remains controversy as to whether EVT should be offered to all elderly patients, and optimal patient selection and management strategies remain elusive. Methods This review consolidates the current literature on the overall efficacy and safety of EVT in the elderly population and highlights multiple topics that are particularly relevant to elderly populations. Results/Conclusions Topics discussed include quality of life, patient selection strategies, white matter disease burden, reperfusion of large ischemic cores, bridging thrombolysis, prethrombectomy imaging, as well as technical considerations.