Abstract Background and aims Patients aged ≥80 years were excluded or underrepresented in mechanical thrombectomy (MT) trials, leading to uncertainty regarding the efficacy and safety of MT in this population. This study aimed to evaluate real-world outcomes of MT in very elderly patients. Methods Retrospective, observational study including patients with anterior circulation large vessel occlusion strokes treated with MT 24 hours of symptom onset at a single center in Argentina between August 2024 and October 2025. Patients were stratified by age (80 vs. ≥80 years). Efficacy outcomes were functional outcomes at 90 days, defined as modified Rankin Scale (mRS) scores of 0–1 and 0–2. Safety outcomes included symptomatic intracranial hemorrhage (sICH), in-hospital mortality, and 90-day mortality. Table 1 Figure 1 Results A total of 135 patients were included (82 aged 80 years and 53 aged ≥80 years). Older patients were more frequently women (67% vs. 44%, p= .05) and had higher prior disability (median mRS 2 vs. 0, p= .05). Baseline stroke severity and reperfusion rates were similar between groups. Functional outcomes at 90 days did not differ significantly by age, and rates of sICH were comparable. Although in-hospital and 90-day mortality were numerically higher among patients aged ≥80 years, these differences did not reach statistical significance.Table 1 Figure 1 Conclusions In this real-world cohort, MT in patients aged ≥80 years achieved functional and safety outcomes comparable to younger patients, despite higher baseline disability. Advanced age alone should not be considered a contraindication to MT in routine clinical practice. Conflict of interest nothing to disclose Table 1 - belongs to Results Figure 1 - belongs to Results
Rosales et al. (2026) studied this question.