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Mechanical thrombectomy in children and adolescents: report of five cases and literature review
  1. Pervinder Bhogal1,
  2. Victoria Hellstern2,
  3. Muhammad AlMatter2,
  4. Oliver Ganslandt3,
  5. Hansjörg Bäzner4,
  6. Marta Aguilar Pérez2,
  7. Hans Henkes2,5
  1. 1 Department of Interventional Neuroradiology, Royal London Hospital, London, UK
  2. 2 Neuroradiological Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  3. 3 Neurosurgical Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  4. 4 Neurosurgical Clinic, Neurocenter, Klinikum Stuttgart, Stuttgart, Germany
  5. 5 Medical Faculty, University Duisburg-Essen, Duisburg, Germany
  1. Correspondence to Dr Pervinder Bhogal; bhogalweb{at}aol.com

Abstract

Background Paediatric arterial ischaemic stroke is an important cause of morbidity and mortality among children. Currently, there are no recommendations regarding mechanical thrombectomy in children despite overwhelming evidence of improved outcomes in adults. Therefore, the need for individual case reports and case series is important to highlight potential advantages and disadvantages in this approach.

Case descriptions We retrospectively searched our prospectively maintained database of patients undergoing mechanical thrombectomy for ischaemic stroke. We describe five children, aged between 7 and 17, who underwent mechanical thrombectomy for acute ischaemic stroke. We provide an account of their clinical presentations, operative treatment and postoperative outcome.

Discussion Mechanical thrombectomy in children, especially older children, can be performed safely and with existing devices. Although a randomised controlled trial would provide compelling evidence of the potential advantages to this technique, the lack of this should not prevent the use of this procedure by trained neurointerventionists.

  • stroke
  • thrombectomy
  • paediatrics

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Footnotes

  • Contributors PB: data collection, analysis, overall study design. VH and MA: data collection and analysis. HB and OG: review and editing. HH: guarantor. MAP: data collection, study design, review and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MAP and PB serve as proctors and consultants for phenox. PB serves as a consultant for Neurvana Medical. HH is a co-founder and shareholder of phenox.

  • Patient consent Not required.

  • Ethics approval Baden-Württemburg.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data, which are the basis of this manuscript, were collected in retrospect as a means of quality assurance. There was no scientific intention related to the treatment of the concerning patients ex ante. Neither the collection of data for the purpose of quality management nor the anonymous publication without identifying information requires, according to German law, the consent of the patient or the consultation of the concerning ethics committee (§15 Abs 1 der Berufsordnung der LÄK Baden-Württemberg).

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