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Mechanical Thrombectomy for Pediatric Arterial Ischemic Stroke from Acute M2 Occlusion
Kartik D Bhatia1,2, Elizabeth Pulcine3, Ian Andrews4
1From the Department of Medical Imaging (K.D.B.), Children's Hospital at Westmead, Westmead, New South Wales, Australia Kartik.bhatia@health.nsw.gov.au.
Insights
Mechanical thrombectomy shows promise for pediatric M2 occlusions. This study found excellent outcomes in 6 children treated with mechanical thrombectomy for acute M2 occlusions, suggesting its potential benefit.
Area of Science:
- Neurology
- Pediatric Stroke
- Interventional Neurology
Background:
- Pediatric large-vessel occlusion (LVO) typically has a poor prognosis.
- Mechanical thrombectomy (MT) has emerged as a viable treatment for pediatric LVO.
- The efficacy of MT specifically for pediatric M2 occlusions is not well-established.
Purpose of the Study:
- To evaluate the clinical outcomes of mechanical thrombectomy in pediatric patients with acute M2 occlusions.
- To discuss factors influencing treatment decisions for pediatric M2 occlusions.
Main Methods:
- A multicenter clinical case series of 6 pediatric patients with acute M2 occlusions.
- All patients underwent mechanical thrombectomy.
- Clinical outcomes were assessed using the pediatric modified Rankin Scale (mRS) at 3 months and long-term follow-up.
Main Results:
- All 6 pediatric patients achieved excellent clinical outcomes (pediatric mRS 0-1) at 3 months and final follow-up (median 12 months).
- The age range of patients was 0.9 to 16.0 years (mean 9.2 years).
- No complications were reported in the abstract.
Conclusions:
- Mechanical thrombectomy appears to be a safe and effective treatment for select pediatric patients with acute M2 occlusions.
- Multidisciplinary team discussions are crucial for managing acute pediatric M2 occlusions.
- Further research is warranted to confirm these findings in larger cohorts.
Abstract:
Pediatric large-vessel occlusion has a poor natural history. Recent retrospective studies have demonstrated the potential benefits, feasibility, and safety profile of mechanical thrombectomy in children. However, the role of thrombectomy in pediatric M2 occlusions remains uncertain. In this clinical report, we present a multicenter series of 6 pediatric patients with acute M2 occlusion (female = 1, male = 5; age range, 0.9-16.0 years, mean = 9.2). All 6 patients having undergone thrombectomy had excellent clinical outcomes (pediatric mRS = 0-1) at 3 months and final available follow-up (median, 12 months; range, 3-72 months). Factors relevant to treatment decision-making in pediatric M2 occlusions are discussed, including the important role of multidisciplinary team discussions during acute management.
