Pediatric Thrombectomy

Abstract

Endovascular thrombectomy has played a major role in advancing adult stroke care and may serve a similar role in pediatric stroke care. However, there is a need to develop better evidence and infrastructure for pediatric stroke care. In this work, we review 2 experienced pediatric endovascular thrombectomy programs and examine key design features in both care environments, including a formalized protocol and workflow, integration with an adult endovascular thrombectomy workflow, simplification and automation of workflow steps, pediatric adaptations of stroke imaging, advocacy of pediatric stroke care, and collaboration between providers, among others. These essential features transcend any single hospital environment and may provide an important foundation for other pediatric centers that aim to enhance the care of children with stroke.

Cerebral Digital Subtraction Angiography in Acute Intracranial Hemorrhage: Considerations in Critically Ill Children

“…While we have highlighted the utility of DSA in the diagnosis and management of critically ill children with ICH, its availability, risks, and costs are important limitations to its use. Many pediatric institutions rely on the neurointerventional capabilities of a partner adult hospital for urgent or emergent catheter angiography 87,95 as pediatric neuroangiography training and experience are limited. 10 Regarding risks, diagnostic cerebral angiography is a safe procedure with expected and reported low complication rates, 10 including vessel injury, vasospasm, dissection, stroke, contrast allergy, and nephropathy.…”