Endovascular Treatment of Acute Ischemic Stroke in Patients Younger than 18 Years

Author:

Dalai Sibasankar1,Limaye Uday2,Kolli Satyarao3,Maturu Mohan V. Sumedha3,Narayana Randhi Venkata4,Pati Rajesh3,Korada Suresh Kumar4,Vankineni Kuchelababu5,Sameera Anantamakula6,Datla Aravind Varma7

Affiliation:

1. Department of Interventional Neuroradiology, Medicover Hospitals, Visakhapatnam, Andhra Pradesh, India

2. Department of Neurointervention, Lilavati Hospital, Mumbai, Maharashtra, India

3. Department of Neurology, Medicover Hospitals, Visakhapatnam, Andhra Pradesh, India

4. Department of Neurology, Seven Hills Hospitals, Visakhapatnam, Andhra Pradesh, India

5. Department of Anaesthesiology and Critical Care, Seven Hills Hospitals, Visakhapatnam, Andhra Pradesh, India

6. Department of Radiodiagnosis, Medicover Hospitals, Visakhapatnam, Andhra Pradesh, India

7. Department of Internal Medicine, Medicover Hospitals, Visakhapatnam, Andhra Pradesh, India

Abstract

AbstractRapid and effective revascularization is very important in the treatment of acute ischemic stroke (AIS). Endovascular treatment is a promising modality in the management of AIS in young patients. We evaluated the clinical and imaging records in 14 patients younger than 18 years presenting within 6 hours of AIS. They received endovascular therapy (ET) either by mechanical thrombectomy, thromboaspiration, or both (Solumbra) between July 2017 and June 2021 in our institute. The National Institute of Health Stroke Scale (NIHSS) score was calculated on admission and before the discharge of all patients. The 90-day modified Rankin Scale (mRS) score on disability-free outcome was also evaluated. The mean preprocedure NIHSS score was 10.78 ± 2.11 that improved to 4.5 ± 1.88 after the procedure. Thrombolysis in cerebral infarction (TICI) grade 2b and 3 blood flow could be established in 12 (85.72%) patients. One patient had TICI 2a flow and one patient had recurrent occlusion despite repeated recanalization (TICI grade 0). The disability-free outcome, mRS score at 90 days was 0 to 1 in 12 (85.72%) patients, mRS score 2 in one (7.14%) patient, and mRS score 3 in one patient (7.14%). We did not have any major complication related to the procedure. ET provides high rates of arterial recanalization and favorable disability-free outcomes in young patients with AIS.

Publisher

Georg Thieme Verlag KG

Subject

Radiology, Nuclear Medicine and imaging

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