ABSTRACT NUMBER: ESOC2026A2026 IMPACT OF ENDOVASCULAR TREATMENT IN PATIENTS AGED ≥85 YEARS WITH LARGE VESSEL OCCLUSION ISCHEMIC STROKE

Abstract Background and aims To evaluate functional outcomes and mortality in patients aged ≥85 years with large vessel occlusion (LVO) ischemic stroke managed with endovascular therapy (EVT). Methods We conducted a prospective, multicenter observational study including patients aged ≥85 years with LVO treated in seven Stroke Centres in Madrid over one year (from February 2024). Patients treated with EVT were compared with those managed without EVT. Inverse probability of treatment weighting (IPTW) based on propensity scores was applied to adjust for baseline differences between groups. Results A total of 277 patients were included (71% women), with a mean age of 89.2 ± 3.11 years and a median baseline mRS of 1 (IQR 0–4). EVT was performed in 188 patients (67.8%). Patients treated with EVT had less pre-stroke cognitive impairment and higher NIHSS scores. After IPTW adjustment, there were no significant differences in functional independence at 3 months (mRS 0–2) between EVT and non-EVT patients (31.1% vs 24.7%; p = 0.31; OR = 1.41, 95% CI 0.72–2.72). However, EVT was associated with a higher proportion of favorable outcomes when considering the mRS 0–3 (50.0% vs 31.9%; p = 0.035; OR = 1.92, 95% CI 1.05–3.52) and with lower 3-month mortality (29.3% vs 50.9%; p = 0.038; OR = 0.51, 95% CI 0.27–0.96). Conclusions In our cohort, EVT did not significantly increase the likelihood of full independence or mild disability (mRS 0–2) at 3 months. However, EVT was associated with reduced mortality and a lower degree of disability among dependent patients. Conflict of interest A. Sánchez Asensio: nothing to disclose, C. Moreno López: nothing to disclose, P. González-Barquero: nothing to disclose, A.M. Iglesias Mohedano: nothing to disclose, M. Vales Montero: nothing to disclose, C. Gómez Escalonilla: nothing to disclose, P. Simal Hernández: nothing to disclose, L. Vidal Guerrero: nothing to disclose, J. Rodríguez Pardo De Donlebun: nothing to disclose, J. Alonso Maroto: nothing to disclose, S. Trillo Senin: nothing to disclose, M. Gutiérrez Sánchez De La Fuente: nothing to disclose, P. Calleja Castaño: nothing to disclose, R. Velasco Calvo: nothing to disclose, J. Carneado-Ruiz: nothing to disclose, A. Cruz Culebras: nothing to disclose, S. García Madrona: nothing to disclose, J. Masjuan Vallejo: nothing to disclose y R. Vera Lechuga: nothing to disclose.