• Danilo Toni, Svetlana Lorenzano, Giancarlo Agnelli, Donata Guidetti, Giovanni Orlandi, Andrea Semplicini, Vito Toso, Valeria Caso, Giovanni Malferrari, Simona Fanucchi, Luigi Bartolomei, and Massimiliano Prencipe.
• Unità di Trattamento Neurovascolare, Department of Neurological Sciences, University of Rome La Sapienza, Rome, Italy. danilo.toni@uniroma1.it
• Cerebrovasc. Dis. 2008 Jan 1; 25 (1-2): 129-35.

BackgroundIntravenous (i.v.) thrombolysis with rt-PA within 3 h from symptom onset is the only approved treatment of pharmacological revascularization in acute ischemic stroke. However, little information exists on its use in elderly patients, in particular those aged >80 years, who at present are excluded from treatment.MethodsIn a multicenter Italian study on i.v. thrombolysis, patients aged >80 years (n = 41) were compared with those aged ResultsThe percentage of SICH (nonfatal and fatal) was comparable between older (2.4%, 2.4%) and younger (2.4%, 2.4%) patient groups (p = 1.0). At 3 months, favorable outcome occurred in 44% and dependence in 22% of the older, and respectively in 58.5 and in 30.9% of the younger patients (p = 0.897). Patients aged >80 years had a higher mortality (34.1%) as compared to those aged 80-year-old group.ConclusionsAcute ischemic stroke patients aged >80 years treated with i.v. rt-PA have a higher mortality than younger patients, but there are no differences for SICH nor for favorable outcome. Our data suggest that thrombolytic therapy should not be a priori denied for appropriately selected >80-year-old patients but randomized controlled clinical trials are necessary before definite recommendations can be given.Copyright (c) 2007 S. Karger AG, Basel.

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