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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

12.4K

Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke: A Multi-Institutional Experience of Technical and

Vijay M Ravindra1,2,3, Matthew Alexander4, Philipp Taussky1

  • 1Department of Neurosurgery, University of Utah School of Medicine, Division of Pediatric Neurosurgery, Primary Children's Hospital, Salt Lake City, Utah.

Neurosurgery
|August 8, 2020
PubMed

Insights

Endovascular thrombectomy effectively treated pediatric stroke, achieving high recanalization rates and good functional outcomes in 86% of patients within 90 days. This study highlights the procedure's promise for children with large-vessel occlusions.

Area of Science:

  • Pediatric Neurology
  • Interventional Neuroradiology
  • Stroke Medicine

Background:

  • Acute ischemic stroke in children, particularly with large-vessel occlusions, presents unique challenges.
  • Limited data exists on the efficacy and technical success of endovascular thrombectomy in pediatric populations.

Purpose of the Study:

  • To evaluate the technical and clinical outcomes of endovascular thrombectomy for acute ischemic stroke in pediatric patients.
  • To assess recanalization rates and functional recovery following the procedure.

Main Methods:

  • A retrospective cohort study was conducted involving 21 pediatric patients treated at 5 US tertiary care facilities between April 2017 and April 2019.
  • Data collected included initial and postprocedural modified Thrombolysis in Cerebral Infarction (mTICI) grade, Pediatric National Institutes of Health Stroke Scale (PedNIHSS) scores, and 90-day pediatric modified Rankin scale (mRS) scores.

Main Results:

  • Successful recanalization (mTICI grade ≥ 2b) was achieved in 83% of the 23 thrombectomies performed.
  • The median PedNIHSS score significantly improved from 13 at presentation to 2 at discharge.
  • A favorable functional outcome (mRS score 0-2) was achieved by 86% of patients at 90 days.

Conclusions:

  • Endovascular thrombectomy is a safe and effective treatment for acute ischemic stroke in children with large-vessel occlusions.
  • The procedure demonstrated high rates of successful recanalization and excellent clinical outcomes in this pediatric cohort.
  • Further prospective studies are warranted to confirm these findings and optimize treatment strategies.
Abstract

Keywords:
AnticoagulationCerebrovascularEndovascularIschemic strokePediatricsThrombectomy

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