Successful Endovascular Therapy for Acute Basilar Thrombosis in an Adolescent

Kirton, Adam; Wong, John H.; Mah, Jean K.; Ross, Bryony; Kennedy, James A.; Bell, Katherine; Hill, Michael D.

doi:10.1542/peds.112.3.e248

Cited by 92 publications

(57 citation statements)

References 47 publications

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“…This study reported favorable outcomes in the endovascular treatment group as compared with controls 54 . Combined angioplasty and thrombolysis, with or without stent placement, has also been used in patients with basilar artery occlusion 55,56 .…”

Section: Angioplasty and Stentingmentioning

confidence: 99%

Guidelines for acute ischemic stroke treatment: part II: stroke treatment

Martins¹,

Freitas²,

Pontes-Neto³

et al. 2012

Arq. Neuro-Psiquiatr.

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Section: Angioplasty and Stentingmentioning

confidence: 99%

Guidelines for acute ischemic stroke treatment: part II: stroke treatment

Martins¹,

Freitas²,

Pontes-Neto³

et al. 2012

Arq. Neuro-Psiquiatr.

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“…81,82,83,84,85 In adults the absolute risk reduction for poor outcome is approximately 15% with thrombolysis, with a number needed to treat of 7-8 in the largest RCCT. 86 Careful patient selection and adherence to protocol are critical to optimize the risk:benefit balance of thrombolytic therapy in adults 87,88 but no studies in pediatric stroke have been completed..…”

Section: Hyperacute Treatment: Thrombolysismentioning

confidence: 99%

“…89 Alternative acute in-terventions including mechanical clot manipulation and cerebral angioplasty have only been described in isolated pediatric cases. 84,90 In the case of severe CSVT, the role of catheter-introduced administration of thrombolytics agents remains controversial and could be considered a last resort for children with severe, progressive disease who are failing systemic anticoagulation.…”

Section: Hyperacute Treatment: Thrombolysismentioning

confidence: 99%

Therapeutic approaches and advances in pediatric stroke

Kirton¹,

deVeber²

2006

Neurotherapeutics

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Summary:Evidence-based therapeutic interventions for pediatric ischemic cerebrovascular disease are beginning to emerge. The primary therapeutic target is usually the pathological prothrombotic disturbance that underlies the majority of pediatric stroke. A battle between anticoagulation and anti-platelet therapies continues to provide controversy and is the inspiration for upcoming randomized trials. Supportive care and neuroprotective strategies are an important consideration in children with stroke. Attempts to determine the safety of acute thrombolytic interventions are also underway. Finally, unique medical and surgical treatments for specific diseases leading to stroke in children continue to evolve. After briefly summarizing the epidemiology, pathophysiology, diagnosis, and outcomes of ischemic strokes in children, treatment approaches and alternatives will be reviewed in detail with emphasis placed on current areas of controversy and future directions for clinical research.

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“…Recently 2 cases were reported in which children with vertebrobasilar thrombosis benefited from rtPA therapy up to 36 hours after symptom onset. 7,8 Despite the high risk of complications, the poor natural history of basilar artery occlusion in both cases justified the aggressive treatment approach.…”

Section: P R Ac T I C Ementioning

confidence: 99%