A paediatric case of basilar occlusion treated with mechanical thrombectomy using stent retrievers

Sánchez, Castel; Parrilla, G.; Villalba, B. García; Martínez, H.; Salcedo, E. Martínez; Domínguez, S. Reyes

doi:10.1016/j.nrleng.2014.05.004

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…The 68 included articles 9–77 were published between 2001 and 2023 (Supporting Information S2: File 2). The main articles included case reports ( n = 48, 71 patients), prospective cohort studies ( n = 7, 215 patients), literature reviews ( n = 5), retrospective cohort studies ( n = 6, 209 patients), case series ( n = 1, nine patients), and systematic reviews ( n = 1, 235 patients).…”

Section: Resultsmentioning

confidence: 99%

“…Tables 1, 2, and 3 present the main characteristics of the interventions and the evaluated outcomes. There were 11 reports describing the use of IVT 10,12,17,18,22,25,32,44,49,51,77 ; eight reports of the use of the intra‐arterial modality; 9,12,14,20,21,26,27,58 and 52 articles reporting interventions based on MT 13,15,16,19,23,24,26,29–43,45–50,52–57,59,61,63–77 …”

Section: Resultsmentioning

confidence: 99%

“…There were 11 reports describing the use of IVT 10,12,17,18,22,25,32,44,49,51,77 ; eight reports of the use of the intra-arterial modality; 9,12,14,20,21,26,27,58 and 52 articles reporting interventions based on MT. 13,15,16,19,23,24,26,[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][48][49][50][52][53][54][55][56]…”

Section: Synthesis Of Included Studiesmentioning

confidence: 99%

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A scoping review of cerebral reperfusion therapies in childhood and adolescence with arterial ischemic stroke

Garcia,

Zuliani,

Mendes‐Chillof

et al. 2023

Annals of the Child Neurology Society

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BackgroundManagement of pediatric stroke is challenging because of the paucity of data supporting the efficacy of interventions. This scoping review details the treatments available for the acute phase of stroke in pediatric patients with arterial ischemic stroke.Summary of ReviewOverall, 68 relevant articles were published between 2001 and 2023. The primary study included 48 case reports (n = 48). Eleven articles reported the use of intravenous thrombolysis (IVT) with alteplase, eight used intra‐arterial (IA) alteplase, and 52 reported mechanical thrombectomy (MT). IVT was administered to 195 patients with a median of 5.5 h of stroke onset, and only four (2.0%) had intracranial hemorrhage after alteplase treatment. Of the 11 articles, nine used 0.9 mg/kg IVT administered as a 10% bolus, with the remaining 90% administered over one hour, and one study used 0.54 mg/kg. IA was performed in 17 patients with a median of 5.05 h of stroke onset, and three individuals (17.6%) had intracranial hemorrhage. Of the eight reports that document IA, two used 0.9 mg/kg; one each used 0.16 mg/kg, 0.1 mg/kg, 0.6 mg/kg, 100 mg/day, and 10 mg/day; and one article documented the use of urokinase 750 000 IU. MT was used in 434 and 215 individuals in a previous systematic review, with a median of 11.82 h of stroke onset, and only 2.9% had intracranial hemorrhage after the treatment. Stent retrievers were used in 33 reports (63.5%) and aspiration retrievers were mentioned in 15 articles (28.8%). Overall, the outcomes ranged from complete to moderate recovery for all modalities.ConclusionsIVT and MT are safer than IA; however, despite the lack of clinical trials, all modalities seem effective in improving clinical recovery. To guide clinical practice and determine better intervention modalities, clinicians should note the key messages from this review, such as using magnetic resonance imaging in the acute phase and identifying key risk factors and presenting symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Synthesis Of Included Studiesmentioning

confidence: 99%

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A scoping review of cerebral reperfusion therapies in childhood and adolescence with arterial ischemic stroke

Garcia,

Zuliani,

Mendes‐Chillof

et al. 2023

Annals of the Child Neurology Society

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Childhood acute basilar artery thrombosis successfully treated with mechanical thrombectomy using stent retrievers: case report and review of the literature

et al. 2016

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To our knowledge, only nine cases of ABAO in children treated with intra-arterial thrombectomy have been previously reported in the literature. In only three cases, the Solitaire stent was applied. Our case is the first case of basilar artery occlusion treated with Solitaire stent, in a child under 24 months. The reports that are available so far indicate that basilar artery recanalization in children can be achieved safely and with excellent clinical outcome using endovascular thrombectomy with the new generation self-expanding and retrievable stents.

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Extended time window mechanical thrombectomy for pediatric acute ischemic stroke

Aburto-Murrieta

Mendez

Márquez-Romero

2022

J Cent Nerv Syst Dis

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Endovascular thrombectomy (EVT) for the treatment of acute ischemic stroke (AIS) remains an off-label procedure seldom utilized in the pediatric population; this holds especially true for patients presenting outside the standard 6-hour time window. In this review we describe the published literature regarding usage of the extended time window EVT in pediatric stroke. We searched PubMed for all pediatric AIS cases and case series that included patients treated with extended time window EVT. We found data from 38 cases found in 27 publications (15 case reports and 12 case series). The median age was 10 years; 60.5% males. The median NIHSS before EVT was 13 with a median time-to-treatment of 11 hours. The posterior circulation was involved in 50.0%. Stent retrievers were used in 68.5%, and aspiration in 13.2%. Angiographic outcome TICI ≥2B was achieved in 84.2%, whereas TICI˂2B was reported in 10.6%. A favorable clinical outcome (NIHSS score ≤4, modified Rankin score ≤1, or Pediatric Stroke Outcome measure score ≤1) occurred in 84.2%. Eight cases that did not report the clinical outcome employing a standardized scale described mild to absent neurological residual deficits. This study found data that supports that extended window EVT produces high recanalization rates and good clinical outcomes in pediatric patients with AIS. Nevertheless, the source materials are indirect and contain substantial inconsistencies with an increased risk of bias that amount to low evidence strength.

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A paediatric case of basilar occlusion treated with mechanical thrombectomy using stent retrievers

Cited by 3 publications

References 18 publications

A scoping review of cerebral reperfusion therapies in childhood and adolescence with arterial ischemic stroke

A scoping review of cerebral reperfusion therapies in childhood and adolescence with arterial ischemic stroke

Childhood acute basilar artery thrombosis successfully treated with mechanical thrombectomy using stent retrievers: case report and review of the literature

Extended time window mechanical thrombectomy for pediatric acute ischemic stroke

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