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Abstract
Background: Treatment of acute cerebral infarction reperfusion with intravenous rt-PA fibrinolysis and/or endovascular intervention has been shown to be effective and safe in non - elderly patients. However, this treatment for patients ≥ 80 years old has not been studied in Vietnam. This study investigate the rate of symptomatic intracerebral hemorrhage and some related factors in very elderly patients with acute cerebral infarction treated with reperfusion with intravenous rt-PA fibrinolysis and/or endovascular intervention.
Methods: A descriptive, cross - sectional study on all patients ≥ 80 years old diagnosed with acute cerebral infarction admitted to inpatient treatment at the Department of Cerebrovascular Diseases of People’s Hospital 115, Ho Chi Minh City during the period from December 2019 to December 2020.
Results: The rate of any complication of intracerebral hemorrhage after reperfusion therapy in the study was 38.2% (n = 26), of which symptomatic intracerebral hemorrhage accounted for 8.8% (n = 6) and asymptomatic intracerebral hemorrhage was 29.4% (n = 20). Hypertension was the most common risk factor accounting for 88.2% (n = 60), followed by atrial fibrillation at 25% (n = 17), diabetes at 20.6% (n = 14), and previous stroke at 16.2% (n = 11). The two causes of arterial occlusion accounted for the highest rate: large artery atherosclerosis 54.4% (n = 37) and embolism from the heart 41.2% (n = 28). Successful revascularization, indicated by an mTICI score of 2b or 3, was achieved in 88.3% of patients (n = 60). The adverse complication during the procedure was thromboembolism causing distal embolism in 2 patients (2.9%). mTICI after reperfusion therapy, door - to - inguinal time, door - to - angiographic reperfusion time, NIHSS score, and systolic blood pressure at admission did not differ between the 2 groups of symptomatic intracerebral hemorrhage (n = 6) and the asymptomatic with and without hemorrhage (n = 62). However, there was a statistically significant difference in the cause of cerebral infarction based on the TOAST classification (p = 0.021) between the two groups.
Conclusions: In our study, the rate of symptomatic intracerebral hemorrhage was 8.8% in very elderly patients with acute cerebral infarction treated with reperfusion therapy, including intravenous rt-PA fibrinolysis and/or endovascular intervention. The cause of cerebral infarction, according to the TOAST classification, was identified as a contributing factor.
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| Published | 28-12-2024 | |
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| Issue | No. 90 (2023) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.90.7 | |
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