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Endovascular Treatment of Pediatric Ischemic Stroke: a Single Center Experience and Review of the Literature

2021Journal article Open access
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dc.contributor.authorFragata, I
dc.contributor.authorMorais, T
dc.contributor.authorSilva, R
dc.contributor.authorPaiva Nunes, A
dc.contributor.authorLoureiro, P
dc.contributor.authorMartins, JD
dc.contributor.authorPamplona, J
dc.contributor.authorCarvalho, R
dc.contributor.authorBaptista, M
dc.contributor.authorReis, J
dc.date.accessioned2022-04-28T14:46:10Z
dc.date.available2022-04-28T14:46:10Z
dc.date.issued2021
dc.description.abstractIntroduction: Mechanical thrombectomy is standard treatment for large vessel occlusion (LVO) in adults. There are no randomized controlled trials for the pediatric population. We report our single-center experience with thrombectomy of LVO in a series of pediatric patients, and perform a review of the literature. Methods: Retrospective review of consecutive pediatric thrombectomy cases between 2011 and 2018. Demographic variables, imaging data, technical aspects and clinical outcome were recorded. Results: In a period of 7 years, 7 children were treated for LVO at our center. Median age was 13 (2-17), and median Ped-NIHSS was 15 (3-24), and the median ASPECTS was 8 (2-10). Five patients had cardiac disease, and 2 of them were under external cardiac assistance. Median time from onset of symptoms to beginning of treatment was 7h06m (2h58m-21h38m). Five patients had middle cerebral artery occlusions. Thrombectomy was performed using a stentriever in 3 patients, aspiration in 3 patients, and combined technique in 1 patient. Six patients had good recanalization (TICI 2 b/3). There were no immediate periprocedural complications. At 3 months, 4 patients (57%) were independent (mRS score <3). Two patients died, one after haemorrhagic transformation of an extensive MCA infarct, and one due to extensive brainstem ischemia in the setting of varicella vasculitis. Discussion: Selected pediatric patients with LVO may be treated with mechanical thrombectomy safely. In patients under external cardiac assistance and under anticoagulation, thrombectomy is the only alternative for treatment of LVO. A multidisciplinary approach in specialized pediatric stroke centers with trained neurointerventionalists are essential for good results.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInterv Neuroradiol. 2021 Feb;27(1):16-24.pt_PT
dc.identifier.doi10.1177/1591019920958827.pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4051
dc.language.isoengpt_PT
dc.publisherSagept_PT
dc.subjectCHLC NRADpt_PT
dc.subjectHDE NEU PEDpt_PT
dc.subjectCHLC NEUpt_PT
dc.subjectHSM CAR PEDpt_PT
dc.subjectAdolescentpt_PT
dc.subjectChildpt_PT
dc.subjectHumanspt_PT
dc.subjectAdultpt_PT
dc.subjectBrain Ischemia* / diagnostic imagingpt_PT
dc.subjectBrain Ischemia* / surgerypt_PT
dc.subjectIschemic Stroke*pt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectStroke* / diagnostic imagingpt_PT
dc.subjectStroke* / surgerypt_PT
dc.subjectThrombectomypt_PT
dc.titleEndovascular Treatment of Pediatric Ischemic Stroke: a Single Center Experience and Review of the Literaturept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage24pt_PT
oaire.citation.startPage16pt_PT
oaire.citation.titleInterventional Neuroradiologypt_PT
oaire.citation.volume27pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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