Abstract Details

Title Acute Ischemic Stroke Large Vessel Occlusion treated with Mechanical Thrombectomy in the Pediatric Populatio

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-015

Objective

We sought to assess the safety and efficacy of mechanical thrombectomy performed in children at our institution for acute ischemic stroke (AIS) due to large vessel occlusion (LVO).

Background

AIS due to large vessel occlusion (LVO) is relatively rare in the pediatric population, and evidence supporting thrombectomy in children is limited. The use of thrombectomy in the pediatric population is extrapolated from data in the adult stroke literature.

Design/Methods We performed a retrospective chart review of pediatric patients (age < 18 years) with AIS due to LVO who underwent thrombectomy at our comprehensive academic stroke center from January 2019 to June 2022.

Results We identified 4 cases of pediatric AIS with LVO treated with thrombectomy. The mean age was 12 years old (range, 9-17), 3 were males. The mean National Institutes of Health Stroke Scale was 16 (range, 10 to 28). One patient received partial thrombolysis (aborted with 20% of dose received). Prior to thrombectomy, 1 patient had CT brain perfusion which showed MCA mismatch favorable for thrombectomy, whereas the remaining 3 patients had MRI brain showing acute infarct in the territory of LVO. LVO sites included M1 occlusion (2), carotid T occlusion (1), and M2 occlusion (1). All 4 patients had successful revascularization including 3 patients with thrombolysis in cerebral infarction (TICI) 3 and 1 patient with TICI 2b. There were no symptomatic hemorrhages. The mean time from last known normal to groin puncture was 5.7 hours (range, 2.9 to 9.2). The clinical outcomes included 2 patients with modified rankin scores (mRS) 1 and 2 patients with mRS 3.

Conclusions

In our case series of pediatric AIS cases with LVO, thrombectomy was feasible and associated with successful revascularization. There were no safety concerns. The majority of cases were diagnosed by MRI brain, highlighting the difficulty in diagnosis of LVO in the pediatric population.

Authors/Disclosures
Jessica Glenn, NP (OSUWMC) PRESENTER	Mrs. Glenn has nothing to disclose.
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center)	Dr. Lee has nothing to disclose.
	No disclosure on file
Warren D. Lo, MD, FAAN (Nationwide Childrens Hospital)	The institution of Dr. Lo has received research support from NIH. Dr. Lo has received publishing royalties from a publication relating to health care.
Cassandra Forrest (Wexner medical Center)	Cassandra Forrest has nothing to disclose.
	No disclosure on file
	No disclosure on file

��ɫ��

��ɫ��