Non-stenotic Carotid Plaques in Embolic Stroke of Unknown Source

Journal article

Stroke is a leading cause of disability and death worldwide. According to Slawski et al. (2018), strokes will more than double in 2050, with the greatest percentage of affected patients being over the age of 75. Administering interventions to patients affected by acute ischemic stroke (AIS) has been a controversial topic when elderly patients were involved (Alawieh et al., 2018). Elderly patients have been known to be excluded from clinical trials solely due to their age and comorbidities (Karhi et al., 2018). The purpose of this project was to determine if the use of endovascular thrombectomy (EVT) is recommended for elderly patients over the age of 75 years of age who have suffered an acute ischemic stroke from a large vessel occlusion (LVO). Six studies met inclusion and were included in this systematic review. The overall findings of this systematic review suggest the use of EVT to be effective for elderly patients over the age of 75 years of age who have suffered an AIS from an LVO. Despite high mortality rates and less favorable outcomes in the elderly cohorts in the six studies, four of the six articles concluded that the alternative of not providing thrombectomy could have detrimental outcomes. Implications of this systematic review include the importance of the advanced practice nurse’s (APRN) role in advocating and educating patients and families about the benefits of receiving thrombectomy after suffering an AIS from an LVO. In addition, APRNs should educate their colleagues about the evidence regarding thrombectomy in order help bridge the gap in the lack of knowledge regarding EVT in the elderly population

Authors: Kamtchum-Tatuene, J; Nomani, AZ; Falcione, S; Munsterman, D; Sykes, G

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Frontiers Media
• Journal: Frontiers in Neurology
• Volume: 12
• Pages: 719329-719329
• Article number: 719329
• Publication date: 2021-09-22
• DOI: 10.3389/fneur.2021.719329
• EISSN: 1664-2295
• ISSN: 1664-2295
• Language: English
• Keywords: Etiology; Incidence (geometry); Radiology; Ischemia; Ischemic stroke; Patent foramen ovale; Internal medicine; Medicine; Cardiology; Atrial fibrillation; Embolic stroke; Stroke (engine)