Open AccessThrombectomy in Childhood Stroke
Author(s) -
Sporns Peter B.,
Kemmling André,
Hanning Uta,
Minnerup Jens,
Sträter Ronald,
Niederstadt Thomas,
Heindel Walter,
Wildgruber Moritz
Publication year - 2019
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.118.011335
Subject(s) - medicine , interquartile range , modified rankin scale , stroke (engine) , pediatric stroke , retrospective cohort study , cerebral infarction , randomized controlled trial , pediatrics , emergency medicine , surgery , ischemic stroke , ischemia , mechanical engineering , engineering
Background Several randomized trials have shown the efficacy of thrombectomy for large intracranial vessel occlusions in adults. However, the safety and efficacy of thrombectomy in children are unknown. We aimed to investigate the feasibility and outcome of thrombectomy in pediatric patients. Methods and Results We performed a retrospective analysis of all children (<18 years of age) who presented with large‐vessel occlusion and were treated with mechanical thrombectomy at 3 German tertiary‐care stroke centers. Interventional results and clinical outcomes were assessed using the Pediatric National Institutes of Health Stroke Scale at 24 hours and on day 7 after thrombectomy as well as after 3 months (modified Rankin Scale). After screening of local registries for all performed thrombectomies, 12 children were included. Median Pediatric National Institutes of Health Stroke Scale score on admission was 12.5 (interquartile range 8.0‐21.5). Angiographic outcomes for thrombectomy were good in all patients (6×modified Treatment in Cerebral Infarction Score 3, 6×modified Treatment in Cerebral Infarction Score 2b). Moreover, most patients showed an improvement of neurological outcome after thrombectomy with a median Pediatric National Institutes of Health Stroke Scale of 3.5 (interquartile range 1‐8) at day 7 and a modified Rankin Scale of 1.0 (interquartile range 0‐2.0) at 3 months. No major periprocedural complications were observed. Conclusions In our retrospective study thrombectomy was safe in childhood stroke, and treated children had good neurological outcomes.