Thrombectomy for Acute Stroke in Childhood: A Case Report, Literature Review, and Recommendations

Buompadre, María Celeste; Andres, Kathleen; Slater, Lee-Anne; Mohseni-Bod, Hadi; Guerguerian, Anne‐Marie; Branson, Helen M.; Laughlin, Suzanne; Armstrong, David W.; Moharir, Mahendranath; deVeber, Gabrielle; Humpl, Tilman; Honjo, Osami; Keshavjee, Shaf; Ichord, Rebecca; Pereira, Vítor Mendes; Dlamini, Nomazulu

doi:10.1016/j.pediatrneurol.2016.09.007

Cited by 40 publications

(22 citation statements)

References 25 publications

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“…8 No clinical trials have evaluated outcomes of pediatric endovascular therapy, with evidence coming from case reports and single center series. [9][10][11][12][13][14] We aimed to report the utilization of endovascular therapy in pediatric AIS, identify characteristics associated with receipt of endovascular therapy, and explore associated outcomes among a nationally representative sample of children with AIS in the United States (US).…”

mentioning

confidence: 99%

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Wilson

Eriksson

Williams

2017

Pediatric Neurology

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In a national sample of children with a diagnosis of arterial ischemic stroke, endovascular therapy was infrequently utilized. Patients with a procedure code for endovascular therapy had significant stroke-related deficits, but outcomes were similar to those in children who did not receive endovascular therapy. Our data, in conjunction with evidence of benefit in adults, support consideration of endovascular therapy for select children with acute stroke.

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confidence: 99%

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Wilson

Eriksson

Williams

2017

Pediatric Neurology

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“…However, many of these case series have demonstrated good outcomes. 51,52 There are no strong pediatric clinical trial data to guide the decision to attempt endovascular thrombectomy. According to a consensus statement from the American Heart Association/American Stroke Association in 2019, endovascular thrombectomy should be considered only in pediatric patients with persistent disabling neurological deficits (Pediatric NIH stroke scale score >6) at the time of intervention and radiographically confirmed cerebral large artery occlusion.…”

Section: Arterial Ischemic Strokementioning

confidence: 99%

“…There have been only small case series looking at endovascular thrombectomy for pediatric AIS. However, many of these case series have demonstrated good outcomes 51,52 . There are no strong pediatric clinical trial data to guide the decision to attempt endovascular thrombectomy.…”

Section: Treatmentmentioning

confidence: 99%

Pediatric stroke in the emergency department

Baldovsky

Okada

2020

JACEP Open

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“…Initial case selection would likely involve teenagers and adhere to the criteria for benefit from RCTs in which diagnosis is made well within six hours of stroke onset, the preceding IV tPA has been unsuccessful, there is occlusion of the proximal Circle of Willis, and the infarct core is small. To date there have been only a few reported cases of pediatric thrombectomy in AIS and the safety and efficacy of thrombectomy in children is currently unknown (Buompadre et al, 2017). Moving forward, there will need to be a registry of complications and outcomes of treated cases to determine efficacy.…”

Section: Strokementioning

confidence: 99%

Expected future developments in child neurology

Tein¹

2019

JICNA

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We stand on the shoulders of giants on the threshold of many new exciting developments in the field of child neurology due to innovations in clinical approach, diagnostic technologies and treatment strategies. There are many exciting new technologies, but we must never forget the power of clinical medicine which allows us to interpret and use these tools with precision and with clinical wisdom. Strong collaborations continue to be needed: between clinicians for the meticulous clinical phenotyping, expansion of the range of phenotypic expression, and the entry of patients into international RCTs (randomised controlled trials); between the biochemists for the biochemical phenotyping and understanding of the basic pathophysiology of the underlying dysregulations and disease mechanisms arising from the protein dysfunctions and the development of robust biomarkers, to evaluate disease severity and response to therapies; and between the geneticists for the understanding of the impact of the exonic or intronic mutations, roles of other regulatory genes on the affected pathway, and epigenetic factors. These collaborations in the aggregate will lead the field forward in terms of increased insight into disease pathophysiology for the development of targeted precision medicine treatment strategies and effective preventative measures. This review is meant to highlight certain selected areas of future development and is not meant to be a comprehensive survey beyond the scope of this review. The subspecialty areas which will be highlighted will include intellectual disability, epilepsy, neuroprotection, neonatal and fetal neurology, CNS infections, headache, autoimmune/inflammatory disorders, demyelinating disorders, stroke, movement disorders, neurotransmitter defects, neuromuscular diseases, neurometabolic disorders, neurogenetic diseases, neuropsychiatry/autism, and neurooncology. In each subspecialty area, I will endeavor to identify emerging diseases, new specific diagnostic technologies and novel therapeutic approaches, but will need to be selective. This review is the culmination of a literature survey for current developments, discussions with leaders in each of the subspecialty fields, who I will acknowledge at the end, and certain personal projections.

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Thrombectomy for Acute Stroke in Childhood: A Case Report, Literature Review, and Recommendations

Cited by 40 publications

References 25 publications

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Endovascular Therapy in Pediatric Stroke: Utilization, Patient Characteristics, and Outcomes

Pediatric stroke in the emergency department

Expected future developments in child neurology

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