Mechanical thrombectomy using a Solitaire stent retriever in the treatment of pediatric acute ischemic stroke
| Autor: | Jun-Yi Xiang, Ming-Zhao Zhang, Bo Li, Xiaodong Lu, Haibo Jiang, Xiaochuan Wang, Bing Zhou |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Subarachnoid hemorrhage Adolescent Mechanical Thrombolysis medicine.medical_treatment Severity of Illness Index Brain Ischemia 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale medicine.artery medicine Anterior cerebral artery Humans cardiovascular diseases 030212 general & internal medicine Child Retrospective Studies Thrombectomy business.industry Cerebral infarction Angiography Digital Subtraction General Medicine Thrombolysis medicine.disease Surgery Stroke Treatment Outcome Middle cerebral artery Balloon dilation Female Stents Internal carotid artery business 030217 neurology & neurosurgery |
| Zdroj: | Journal of neurosurgery. Pediatrics. 23(3) |
| ISSN: | 1933-0715 |
| Popis: | OBJECTIVE Mechanical thrombectomy using a Solitaire stent retriever has been widely applied as a safe and effective method in adult acute ischemic stroke (AIS). However, due to the lack of data, the safety and effectiveness of mechanical thrombectomy using a Solitaire stent in pediatric AIS has not yet been verified. The purpose of this study was to explore the safety and effectiveness of mechanical thrombectomy using a Solitaire stent retriever for pediatric AIS. METHODS Between January 2012 and December 2017, 7 cases of pediatric AIS were treated via mechanical thrombectomy using a Solitaire stent retriever. The clinical practice, imaging, and follow-up results were reviewed, and the data were summarized and analyzed. RESULTS The ages of the 7 patients ranged from 7 to 14 years with an average age of 11.1 years. The preoperative National Institutes of Health Stroke Scale (NIHSS) scores ranged from 9 to 22 with an average of 15.4 points. A Solitaire stent retriever was used in all patients, averaging 1.7 applications of thrombectomy and combined balloon dilation in 2 cases. Grade 3 on the modified Thrombolysis In Cerebral Infarction scale of recanalization was achieved in 5 cases and grade 2b in 2 cases. Six patients improved and 1 patient died after thrombectomy. The average NIHSS score of the 6 cases was 3.67 at discharge. The average modified Rankin Scale score was 1 at the 3-month follow-up. Subarachnoid hemorrhage after thrombectomy occurred in 1 case and that patient died 3 days postoperatively. CONCLUSIONS This study shows that mechanical thrombectomy using a Solitaire stent retriever has a high recanalization rate and excellent clinical prognosis in pediatric AIS. The safety of mechanical thrombectomy in pediatric AIS requires more clinical trials for confirmation. ABBREVIATIONS ACA = anterior cerebral artery; AIS = acute ischemic stroke; CTA = CT angiography; ICA = internal carotid artery; MCA = middle cerebral artery; mRS = modified Rankin Scale; mTICI = modified Thrombolysis In Cerebral Infarction; NIHSS = National Institutes of Health Stroke Scale; rt-PA = recombinant tissue plasminogen activator. |
| Databáze: | OpenAIRE |
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