Mechanical Thrombectomy for Acute Ischemic Stroke: Considerations in Children. Issue 10 (October 2020)

• Record Type: Journal Article
• Authors: Sun, Lisa R.; Harrar, Dana; Drocton, Gerald; Castillo-Pinto, Carlos; Felling, Ryan; Carpenter, Jessica L.; Wernovsky, Gil; McDougall, Cameron G.; Gailloud, Philippe; Pearl, Monica S.
• Is Part Of: Stroke. Volume 51:Issue 10(2020)
• Publication Date: 2020-10
• Subjects: acute stroke -- internal carotid artery -- magnetic resonance angiography -- middle cerebral artery -- patient selection -- thrombectomy; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.120.029698
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : The use of mechanical thrombectomy for the treatment of acute childhood arterial ischemic stroke with large vessel occlusion is increasing, with mounting evidence for its feasibility and safety. Despite this emerging evidence, clear guidelines for patient selection, thrombectomy technique, and postprocedure care do not exist for the pediatric population. Due to unique features of stroke in children, neurologists and interventionalists must consider differences in patient size, anatomy, collateral vessels, imaging parameters, and expected outcomes that may impact appropriate patient selection and timing criteria. In addition, different causes of stroke and comorbidities in children must be considered and may alter the safety and efficacy of thrombectomy. To optimize the success of endovascular intervention in children, a multidisciplinary team should take into account these nuanced considerations when determining patient eligibility, developing a procedural approach, and formulating a postprocedure neurological monitoring and therapeutic plan.