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Published on: August 16, 2021
Successful thrombectomy for acute ischaemic stroke in an infant supported with a single ventricle assist device
Keats Ewing1, Chrisoula Cheronis2, Rohit Seth Loomba1,3
1Cardiology, Ann & Robert H Lurie Children's Hospital of Chicago, USA.
Insights
Acute ischemic stroke in infants is rare, especially in those with congenital heart disease (CHD) on mechanical support. Successful endovascular thrombectomy was performed on an infant with CHD on a ventricle assist device, showing feasibility in select cases.
Area of Science:
- Pediatric Neurology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Acute ischemic stroke is uncommon in infants, posing significant diagnostic and treatment challenges.
- Infants with congenital heart disease (CHD) requiring mechanical circulatory support (MCS) face unique risks, including stroke.
- Mechanical circulatory devices, such as ventricle assist devices (VADs), can complicate stroke management.
Purpose of the Study:
- To report a case of successful endovascular thrombectomy in an infant with CHD on MCS.
- To highlight the feasibility of advanced neurointerventional procedures in this high-risk pediatric population.
- To emphasize the critical role of multidisciplinary collaboration in managing complex pediatric stroke cases.
Main Methods:
- Case report of an infant with CHD on a VAD who experienced an acute ischemic stroke.
- Successful endovascular thrombectomy procedure.
- Multidisciplinary team approach involving pediatric neurology, cardiology, cardiac surgery, and interventional radiology.
Main Results:
- The infant with CHD on a VAD survived an acute ischemic stroke.
- Endovascular thrombectomy was technically successful in restoring blood flow.
- The patient demonstrated a positive outcome following the intervention.
Conclusions:
- Endovascular thrombectomy is a feasible treatment option for select pediatric patients with acute ischemic stroke who are supported by mechanical circulatory devices.
- Successful management requires a coordinated, multidisciplinary approach.
- This case expands the understanding of stroke treatment possibilities in critically ill infants.
Abstract:
Acute ischaemic stroke is rare in infancy and presents unique diagnostic and therapeutic challenges, particularly in patients supported with mechanical circulatory devices. We describe an infant with CHD supported with a single ventricle assist device who developed an acute ischaemic stroke and underwent successful endovascular thrombectomy. This case highlights the feasibility of thrombectomy in select paediatric patients on mechanical circulatory support and underscores the importance of multidisciplinary decision-making.
