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Pediatric Thrombectomy: Design and Workflow Lessons From Two Experienced Centers
David C Lauzier1, Maria M Galardi2, Kristin P Guilliams2,3
1Mallinckrodt Institute of Radiology (D.C.L., M.S.G., A.P.K.), Washington University School of Medicine, St Louis, MO.
Insights
Endovascular thrombectomy shows promise for pediatric stroke care, but requires improved evidence and infrastructure. Reviewing successful programs offers a foundation for enhancing treatment protocols and collaboration for children with stroke.
Area of Science:
- Neurology
- Pediatric Medicine
- Interventional Radiology
Background:
- Endovascular thrombectomy has significantly improved outcomes in adult stroke patients.
- Its application in pediatric stroke care is promising but lacks robust evidence and established infrastructure.
- Developing specialized pediatric stroke care pathways is crucial.
Purpose of the Study:
- To review established pediatric endovascular thrombectomy programs.
- To identify key design features and essential components for successful pediatric stroke care.
- To provide a foundational framework for other pediatric centers.
Main Methods:
- Review of two experienced pediatric endovascular thrombectomy programs.
- Examination of critical care environment design features.
- Analysis of protocols, workflows, imaging adaptations, and provider collaboration.
Main Results:
- Key features include formalized protocols, integration with adult workflows, and workflow automation.
- Pediatric-specific adaptations in stroke imaging and strong provider collaboration are vital.
- Successful programs emphasize advocacy for pediatric stroke care.
Conclusions:
- Essential features for pediatric endovascular thrombectomy programs are transferable across institutions.
- These findings can guide the development and enhancement of pediatric stroke care globally.
- Standardized protocols and collaborative approaches are fundamental for advancing pediatric stroke treatment.
Abstract:
Endovascular thrombectomy has played a major role in advancing adult stroke care and may serve a similar role in pediatric stroke care. However, there is a need to develop better evidence and infrastructure for pediatric stroke care. In this work, we review 2 experienced pediatric endovascular thrombectomy programs and examine key design features in both care environments, including a formalized protocol and workflow, integration with an adult endovascular thrombectomy workflow, simplification and automation of workflow steps, pediatric adaptations of stroke imaging, advocacy of pediatric stroke care, and collaboration between providers, among others. These essential features transcend any single hospital environment and may provide an important foundation for other pediatric centers that aim to enhance the care of children with stroke.
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