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Non-routine thrombectomy in pediatric arterial ischemic stroke.

Sinan Balcı1, Nesibe Gevher Eroğlu-Ertuğrul2, Ahmet Ziya Birbilen3

  • 1Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, Türkiye.

Diagnostic and Interventional Radiology (Ankara, Turkey)
|June 5, 2024
PubMed
Summary

Mechanical thrombectomy for pediatric arterial ischemic stroke (AIS) often requires non-routine techniques. Specialized centers are crucial for adapting adult protocols to effectively treat children with AIS.

Keywords:
Strokeaspirationchildrenstentthrombectomythrombolysis

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Area of Science:

  • Pediatric Neurology
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Mechanical thrombectomy indications and techniques for pediatric arterial ischemic stroke (AIS) are not well-established.
  • Standard adult protocols may need modification for effective pediatric AIS management.

Purpose of the Study:

  • To present six cases of pediatric arterial ischemic stroke (AIS) treated with non-routine mechanical thrombectomy.
  • To highlight unique clinical and procedural aspects of pediatric AIS thrombectomy.

Main Methods:

  • Retrospective review of pediatric AIS cases undergoing non-routine thrombectomy between 2015-2023.
  • Evaluation of patient characteristics, procedural details, and clinical outcomes.

Main Results:

  • Seven non-routine thrombectomy procedures were performed in six children.
  • No procedure-related mortality or major neurologic morbidity; favorable modified Rankin Scale scores at follow-up.
  • Included unique cases such as acute stent occlusion, bilateral carotid and MCA occlusions, and atrial myxoma embolism.

Conclusions:

  • Mechanical thrombectomy in children with AIS may necessitate modifications to standard adult algorithms.
  • Specialized pediatric centers are optimal for managing these complex cases.