الفهرس 
Anatomy of the cerebral circulationOnly 14 pages are availabe for public view
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Abstract
Background and Aim : the efficacy and safety of mechanical thrombectomy for acute ischemic stroke for elderly patients is still to date controversial . We sought to determine if increasing age adversely
affects prognosis. Patients &Methods: An intervention study was conducted on 20 elderly patients with acute ischemic stroke collected retrospectively at international medical center, and other private centers during aperoid of 24 months . According to the median age of 68.5 years, patients were divided into two groups; patients older than 68.5 years which included 10 patients and patients younger than 68.5 years which included 10 patients and compared patients younger than 68.5 years of age with older individuals. We analyzed favorable outcome, successful and futile recanalization , hemorrhagic transformation ,mortality in both groups . Results: A favorable outcome (modified Rankin Scale score ≤2 at 3 months) was reached by 80% in the elderly group and 90% of younger patients .Overall successful recanalization rates were 95% and futile recanalization reached 10% without statistically significant differences between both groups. Only 20% of patients, 10% in each age group developed post-procedural hemorrhage with no statistically significant difference between both groups. No mortality incidence was recorded in both age group. Conclusion: Advanced age should not preclude the use of endovascular revascularization with mechanical devices. from our findings, we strongly recommend further studies with larger sample sizes are required to ensure similar outcomes in regular practice.
It is anticipated that the incidence of stroke will be more than double by 2050,with the largest proportion of these incident cases occurring among elderly aged patients (1).
The main factor that contributed to the positive results of previous trials using mechanical thrombectomy was the ideal selection of patients (2).
Intracranial mechanical thrombectomy is a promising ischemic stroke treatment. There is ongoing interest in the selection of appropriate candidates because it remains unclear which patients benefit the most. The elderly population is predicted to double in a half century, and it is well established that older persons have a higher risk of stroke. (3).
Advanced age also carries with it the burden of decreased neuronal plasticity and an ever-decreasing pool of healthy neurons. A large intracranial vessel occlusion may irreversibly injure a higher proportion of neurons in an elderly patient than it would in a younger patient under similar circumstances, substantially impeding recovery of neurologic function. Thus, elderly patients may incur more disability regardless of treatment technique. (4).
It is critical to investigate the benefit of newer treatments and to understand potential characteristics within this population, which may influence clinical outcome following endovascular therapy (ET). The aim of this substudy was to examine the influence of age on clinical and revascularization outcomes. (5).
In this study we assessed the cost and benefit balance of mechanical thrombectomy for acute ischemic stroke in patients with large cerebral artery occlusion with the first six hours of symptoms onset in relation to the age.