Preliminary experience of mechanical thrombectomy treatment in pediatric arterial ischemic stroke: a retrospective case series

Abstract

To evaluate the feasibility and efficacy of mechanical thrombectomy in the treatment of pediatric acute ischemic stroke (AIS). The clinical data, radiographic results and management outcomes of children diagnosed with AIS and treated at our hospital between 2016 and 2021 were retrospectively analyzed. A total of 8 patients (4 male and 4 female) were included, with a mean age of 7.8 ± 2.8 years. All patients presented with focal neurological deficits at onset, including hemiplegia, facial deviation, mild limb weakness, dizziness, and headache, with Pediatric National Institutes of Health Stroke Scale (PedNIHSS) scores ranging from 4 to 12 on presentation. Six patients had isolated middle cerebral artery occlusion, one bilateral posterior cerebral artery occlusion, and one had combined middle cerebral and anterior cerebral artery occlusion. Half of the patients underwent two mechanical thrombectomy procedures. After treatment, all patients achieved a modified Thrombolysis in Cerebral Infarction (mTICI) score of ≥2b. The median follow up duration was 20.13 months (range, 6–32 months). At the 6-month follow-up, all patients had the pediatric modified Rankin Scale (mRS) scores of 0 to 1. Our preliminary experience suggests that mechanical thrombectomy is technically feasible and may be associated with favorable short- to medium-term functional outcomes in carefully selected pediatric patients with large vessel AIS. However, due to the retrospective design, small sample size, and lack of a control group, further multicenter prospective studies are warranted to better evaluate the safety and clinical outcomes of this procedure in pediatric patients.