中国老年急性大血管闭塞性卒中血管内治疗的现状：ANGEL act注册研究的亚组分析
Current status of endovascular treatment for older adults with acute large vessel occlusion stroke in China: subgroup analysis of ANGEL act registry.
作者信息
Han Bin, Sun Dapeng, Jia Baixue, Tong Xu, Wang Anxin, Mo Dapeng, Gao Feng, Ma Ning, Miao Zhongrong
机构信息
Shanxi Key Laboratory of Brain Disease Control, Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, China.
Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
Front Neurol. 2023 Apr 18;14:1114556. doi: 10.3389/fneur.2023.1114556. eCollection 2023.
BACKGROUND
Although endovascular treatment (EVT) has become the standard treatment for acute large vessel occlusion (LVO), its safety and efficacy in older adults have not been fully determined. The present study aimed to compare the safety and efficacy of EVT for acute LVO between younger (<80 years old) and older adults (≥80 years old) in the Chinese population.
METHODS
The subjects were selected from the ANGEL-ACT registry (endovascular treatment key technique and emergency workflow improvement of acute ischemic stroke). The 90-day modified Rankin score (mRS), successful recanalization, procedure duration, number of passes, intracranial hemorrhage (ICH), and mortality within 90 days were compared after adjusting for confounders.
RESULTS
A total of 1,691 patients, 1,543 classified as young and 148 classified as older, were included. We observed that young and older adults had a similar 90-day mRS distribution, successful recanalization, procedure duration, number of passes, ICH, and mortality within 90 days (all > 0.05). The rate of 90-day mRS 0-3 was found to be higher in young patients than in older adults (39.9% vs. 56.5%, odds ratio = 0.64, 95% confidence interval = 0.44-0.94, = 0.022).
CONCLUSION
We found that patients less than or greater than 80 years of age share similar clinical outcomes, without increasing the risk of ICH and mortality.
背景
尽管血管内治疗（EVT）已成为急性大血管闭塞（LVO）的标准治疗方法，但其在老年人中的安全性和有效性尚未完全确定。本研究旨在比较中国人群中年轻（<80岁）和老年（≥80岁）急性LVO患者接受EVT治疗的安全性和有效性。
方法
研究对象选自ANGEL-ACT注册研究（急性缺血性卒中血管内治疗关键技术及急诊工作流程改进）。在调整混杂因素后，比较90天改良Rankin量表（mRS）评分、血管再通成功情况、手术持续时间、穿刺次数、颅内出血（ICH）及90天内死亡率。
结果
共纳入1691例患者，其中1543例为年轻患者，148例为老年患者。我们观察到，年轻和老年患者在90天mRS评分分布、血管再通成功情况、手术持续时间、穿刺次数、ICH及90天内死亡率方面相似（均>0.05）。发现年轻患者90天mRS 0-3的比例高于老年患者（39.9%对56.5%，优势比=0.64，95%置信区间=0.44-0.94，P=0.022）。
结论
我们发现，年龄小于或大于80岁的患者临床结局相似，且不增加ICH和死亡风险。
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