Các yếu tố liên quan đến quyết định can thiệp nội mạch lấy huyết khối ở người bệnh từ 80 tuổi trở lên bị đột quỵ thiếu máu não cấp: Nghiên cứu thuần tập tiến cứu mô tả đa trung tâm tại Thành phố Hồ Chí Minh

Abstract

The selection of endovascular thrombectomy in patients aged 80 years or older with acute large vessel occlusion stroke remains challenging in clinical practice. We conducted a prospective, multicenter descriptive cohort study between January 2024 and December 2025, including 370 very elderly patients treated at three major stroke centers at Ho Chi Minh City, Vietnam, to identify factors associated with thrombectomy selection in routine clinical practice. Clinical characteristics, imaging findings, and time-related variables were collected and analyzed. Of the 370 patients, 190 (51.4%) underwent endovascular treatment. Multivariable analysis demonstrated that moderate-to-good collateral circulation was strongly associated with a higher likelihood of thrombectomy (adjusted OR = 5.0; p < 0.001), whereas longer onset-to-admission time significantly reduced the probability of intervention (adjusted OR = 0.89 per hour of delay; p < 0.001). Proximal occlusion (internal carotid artery or M1 segment) was also independently associated with treatment selection. In very elderly patients, real-world thrombectomy selection in Vietnam is primarily associated with collateral status, time metrics, and occlusion location.