{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:52:38Z","timestamp":1791301958537,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Randomized trials from high\u2010income countries have shown that endovascular treatment (EVT) yields similar benefits in elderly and non\u2010elderly patients with large vessel occlusion stroke (LVOS). However, evidence from low\/middle\u2010income countries remains scarce. We aimed to assess the impact of age on outcomes and determine whether age modifies the effect of EVT under the resource\u2010limited conditions of a public healthcare system in a developing country.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Pre\u2010specified subgroup analysis of the RESILIENT trial, a multicenter, randomized, controlled trial in Brazil comparing EVT versus medical treatment alone in anterior circulation LVOS. Patients were categorized as non\u2010elderly (&lt;70\u2009years), elderly (\u226570\u2009years), and very elderly (\u226580\u2009years). The primary endpoint was functional independence (modified Rankin scale 0\u20132) at 90\u2009days. Logistic regression was performed to identify independent predictors of outcome and to assess age as an effect modifier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 221 randomized patients (47.1% females; median [IQR] National Institutes of Health Stroke Scale, 18 [14\u201321]), 89 (40.2%) were elderly and 37 (16.7%) very elderly. Increasing age was independently associated with lower odds of functional independence in the entire study population (odds ratio [OR]: 0.97; 95% confidence interval [CI]: 0.95\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Age significantly modified the treatment effect of EVT. Non\u2010elderly patients derived substantial benefit from EVT (OR: 4.08; 95% CI: 1.71\u20139.76), whereas the benefit was attenuated in elderly (OR: 0.90; 95% CI: 0.17\u20135.42;\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u2009=\u20090.03) and very elderly (OR: 0.36; 95% CI: 0.11\u20133.21;\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The effect of EVT appears significantly diminished among elderly patients in a public healthcare system in a developing country. Further studies are needed to understand the mechanism underlying these findings and properly assess the efficacy of EVT in this vulnerable population. ANN NEUROL 2026;100:644\u2013652<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.78281","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T23:25:41Z","timestamp":1784935541000},"page":"644-652","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Age Is an Effect Modifier of Thrombectomy Benefit in a Socioeconomically Vulnerable Stroke Population"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0383-4145","authenticated-orcid":false,"given":"Fabricio O.","family":"Lima","sequence":"first","affiliation":[{"name":"Neurology Service Hospital Geral de Fortaleza  Fortaleza Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9 de A.","family":"Mont'Alverne","sequence":"additional","affiliation":[{"name":"Neurology Service Hospital Geral de Fortaleza  Fortaleza Brazil"},{"name":"Neurointerventional Service Hospital Geral de Fortaleza  Fortaleza Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia C.","family":"Rebello","sequence":"additional","affiliation":[{"name":"Neurology Service Hospital de Base  Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Abud","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Radiology Division Hospital das Cl\u00ednicas \u2010 Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-3123","authenticated-orcid":false,"given":"Gisele S.","family":"Silva","sequence":"additional","affiliation":[{"name":"Neurology and Neurosurgery Department Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Academic Research Organization, Hospital Israelita Albert Einstein S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel E.","family":"Frudit","sequence":"additional","affiliation":[{"name":"Neurointerventional Radiology Service, Federal University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio B.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Federal University of Rio Grande do Sul  Porto Alegre Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamary","family":"Oliveira\u2010Filho","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine  Salvador Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo C.","family":"Haussen","sequence":"additional","affiliation":[{"name":"Department of Neurology Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Emory University School of Medicine  Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-8736","authenticated-orcid":false,"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"Department of Neurology and Comprehensive Stroke Center University of California Los Angeles David Geffen School of Medicine  Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oct\u00e1vio M.","family":"Pontes\u2010Neto","sequence":"additional","affiliation":[{"name":"Department of Neurosciences and Behavioral Sciences Hospital das Cl\u00ednicasRibeir\u00e3o Preto Medical School, University of S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norberto A.F.","family":"Frota","sequence":"additional","affiliation":[{"name":"Neurology Service Hospital Geral de Fortaleza  Fortaleza Brazil"},{"name":"Department of Post\u2010Graduate Medical Sciences 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