Background and Purpose: 
The incidence of ischemic stroke is higher in the older population with higher mortality. Studies have demonstrated clinical benefit when performing thrombectomy. A meta-analysis performed with patient level data from five trials showed that this benefit is also present in patients that are over 80 years old, although increasing age is a negative predictor of clinical outcome and they had a small number of patients in this age category. Our aim is to provide data from clinical practice to assess the safety and efficacy of endovascular thrombectomy in this age group. 

Methods: 
We retrospectively reviewed all consecutive patients of age 80+ referred for thrombectomy due to large vessel occlusion at three international institutions from 01/01/2015 to 31/03/2018. All patients who were brought to the angiographic suite and had a groin puncture with the intention to perform thrombectomy were included in this study. 

Results: 
We had 151 patients with a median age of 85. Baseline clinical characteristics are similar to previous trials. Good clinical outcome (mRS 0-2) at 90 days was achieved in 23% (35/151) patients. Intracranial hemorrhage was present in 10% (15/151) patients. The 90-day mortality rate is 40% (61/151). 

Conclusions: 
Our study adds valuable evidence to the limited available published data on the safety and clinical outcomes in patients 80 years of age and older who undergo acute thrombectomy for large vessel ischemic stroke with modern devices. Overall our results are largely similar to the HERMES meta-analysis data on patients aged 80 years and older, although we had slightly lower rates of good functional outcomes and slightly higher mortality at 3 months. This study supports the delivery of acute thrombectomy for acute ischemic stroke due to large vessel occlusion in a clinical care setting in the elderly population, but further studies on patient selection would be of value.

Acute Thrombectomy in the Ageing Population: A retrospective analysis of radiological and clinical outcomes in acute thrombectomies performed in patients over 80 years