Background Endovascular thrombectomy (EVT) has revolutionized the care of patients with large vessel occlusion (LVO) ischemic stroke. Approximately half achieve functional independence with mortality rates of 19% by day-90. There are limited published data on long-term EVT mortality. We aimed to determine mortality at 1- and 5-years post-EVT.
Methods Consecutive patients with first anterior large vessel occlusion (LVO) treated with EVT between 2011 and December 2023 were included. The setting is a tertiary EVT centre with a catchment population of 2.8 million. Patients were identified from a mandatory national stroke therapy registry. Mortality data up until 1st January 2024 was determined from electronic clinical records. Data were analysed using life tables and Kaplan-Meier methods.
Results Of 1050 patients treated with EVT since 2011, 291 (27.7%) had died by 1st January 2024. Death had occurred in 96 (9.1%) patients by hospital discharge or <7 days, 143 (13.6%) by day-90, 188 (17.9%) by 1-year, and 280 (26.7%) by 5-years. Median survival for patients treated at 75-84 years was 76.6 (95% CI, 58-95) months, and for 85-94 years was 21.5 (7.7-35.2, 95% CI) months (log rank P <0.0001). The lower mortality rates in younger age brackets precluded median analysis.
Conclusion This study shows that just under three quarters of EVT treated LVO stroke patients were still alive at 5-years. Further, survival can be anticipated from a patient’s age at treatment, which can help inform EVT treatment decisions in patients of advanced age.