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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(04): 701-708
DOI: 10.1055/s-0045-1809328
Original Article

A Comparison of Outcome between Two Different Age Groups after Intravenous Thrombolysis for Acute Ischemic Stroke of Anterior Circulation: A Single-Center Experience of 500 Cases

Autor*innen

  • Mohan Karki

    1   Department of Neuro Interventional Surgery, Max Super Speciality Hospital, Vaishali, Uttar Pradesh, India

  • Girish Rajpal

    1   Department of Neuro Interventional Surgery, Max Super Speciality Hospital, Vaishali, Uttar Pradesh, India
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Abstract

Objective

Mechanical thrombectomy (MT) alone or with intravenous thrombolysis (IVT) avoids disabilities in patients with acute ischemic stroke. The purpose of this study is to assess the outcome in two different age groups by combined technique (simultaneous stent retriever plus syringe aspiration) following thrombolysis in anterior circulation stroke and to analyze predictive factors.

Materials and Methods

We retrospectively studied all patients (n = 500) who had ≥ modified thrombolysis in cerebral infarction (mTICI)2b following Solitaire stent retriever MT following IVT. Patients with anterior circulation stroke were dichotomized based on whether younger or older than 50 years. We analyzed predictive factors for favorable clinical outcome and also evaluated the age-related adverse results, with focus on symptomatic intracerebral hemorrhage within 7 days, favorable outcome (modified Rankin scale [mRS] 0–2), and mortality at 3 months following procedure.

Results

Among a total of 500 patients, 144 patients were in the young age group (≤50 years) with a mean age of 37.10 years, and 356 patients were in the old age group (>50 years) with a mean age of 63.55 years. There was a significant association between these two groups in the etiologies, medical history, age, puncture to recanalization time, and adverse results. Similarly, patient age ≤50 years, National Institute of Health Stroke Scale score at admission < 15, Alberta Stroke Program Early CT Score >5, mTICI3, and onset to recanalization time < 4 hours were significantly predictive factors for a favorable outcome.

Conclusion

Our study shows that the combined technique after IVT for anterior circulation stroke in large vessels is safe and effective; however, younger age has a higher rate of favorable outcome with a lower mortality rate.

Keywords

combined technique - intravenous thrombolysis - anterior circulation stroke - Solitaire stent - outcome

Authors' Contributions

M.K. conceived and designed the study, he also contributed to data collection, manuscript writing, and drafting of the manuscript. G. R. was responsible for editing and providing technical feedback on design and analyses.


Ethical Approval

This is a retrospective study, so informed consent was taken from the institute as well as all included participants in this study. This study was approved by local Institutional Review Board.




Publikationsverlauf

Artikel online veröffentlicht:
02. Juni 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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