Sporns, Peter B. and Psychogios, Marios-Nikos and Straeter, Ronald and Hanning, Uta and Minnerup, Jens and Chapot, Rene and Henkes, Hans and Henkes, Elina and Grams, Astrid and Dorn, Franziska and Nikoubashman, Omid and Wiesmann, Martin and Bier, Georg and Weber, Anushe and Broocks, Gabriel and Fiehler, Jens and Brehm, Alex and Kaiser, Daniel and Yilmaz, Umut and Morotti, Andrea and Marik, Wolfgang and Nolz, Richard and Jensen-Kondering, Ulf and Braun, Michael and Schob, Stefan and Beuing, Oliver and Goetz, Friedrich and Trenkler, Johannes and Turowski, Bernd and Mohlembruch, Markus and Wendl, Christina and Schramm, Peter and Musolino, Patricia L. and Lee, Sarah and Schlamann, Marc and Radbruch, Alexander and Karch, Andre and Rubsamen, Nicole and Wildgruber, Moritz and Kemmling, Andre (2021) Clinical Diffusion Mismatch to Select Pediatric Patients for Embolectomy 6 to 24 Hours After Stroke An Analysis of the Save ChildS Study. NEUROLOGY, 96 (3). E343-E351. ISSN 0028-3878, 1526-632X
Full text not available from this repository. (Request a copy)Abstract
Objective To determine whether thrombectomy is safe in children up to 24 hours after onset of symptoms when selected by mismatch between clinical deficit and infarct. Methods A secondary analysis of the Save ChildS Study (January 2000-December 2018) was performed, including all pediatric patients (<18 years) diagnosed with arterial ischemic stroke who underwent endovascular recanalization at 27 European and United States stroke centers. Patients were included if they had a relevant mismatch between clinical deficit and infarct. Results Twenty children with a median age of 10.5 (interquartile range [IQR] 7-14.6) years were included. Of those, 7 were male (35%), and median time from onset to thrombectomy was 9.8 (IQR 7.8-16.2) hours. Neurologic outcome improved from a median Pediatric NIH Stroke Scale score of 12.0 (IQR 8.8-20.3) at admission to 2.0 (IQR 1.2-6.8) at day 7. Median modified Rankin Scale (mRS) score was 1.0 (IQR 0-1.6) at 3 months and 0.0 (IQR 0-1.0) at 24 months. One patient developed transient peri-interventional vasospasm; no other complications were observed. A comparison of the mRS score to the mRS score in the DAWN and DEFUSE 3 trials revealed a higher proportion of good outcomes in the pediatric compared to the adult study population. Conclusions Thrombectomy in pediatric ischemic stroke in an extended time window of up to 24 hours after onset of symptoms seems safe and neurologic outcomes are generally good if patients are selected by a mismatch between clinical deficit and infarct. Classification of Evidence This study provides Class IV evidence that for children with acute ischemic stroke with a mismatch between clinical deficit and infarct size, thrombectomy is safe.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ISCHEMIC-STROKE; THROMBECTOMY; CLASSIFICATION; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 30 Sep 2022 14:21 |
| Last Modified: | 30 Sep 2022 14:21 |
| URI: | https://pred.uni-regensburg.de/id/eprint/48160 |
Actions (login required)
 |
View Item |
