Journal article
Endovascular stroke intervention in the very young
Clinical neurology and neurosurgery, Vol.127, pp.15-18
12/2014
DOI: 10.1016/j.clineuro.2014.09.022
PMID: 25459237
Abstract
•Data on stroke in the very young is lacking and insufficient.•Endovascular therapy can achieve a high recanalization rate and favorable outcome.•Endovascular therapy can have limited complications.•We advise aggressive management for very young patients.
Object: This study aims to evaluate the use of endovascular therapy to treat very young (≤35 years) patients with acute ischemic stroke from large vessel occlusion.
We identified from a prospectively maintained database young patients (≤35 years) undergoing endovascular intervention for AIS at two cerebrovascular referral centers. The study only included patients with a confirmed large vessel occlusion. Modified Rankin scale (mRS) scores were determined at 90 days during a follow-up visit.
A total of 15 patients met the inclusion criteria. Mean age was 27.93 years±6.75 years (range: 9–35 years). On admission, the mean NIHSS score was 14.07±9.16. Mechanical thrombectomy was performed using the Solitaire FR device in 4 of 15 (26.67%) patients and the Merci/Penumbra systems in 11 (73.33%) patients. Successful recanalization (TICI 2–3) was achieved in all but one patient (14/15; 93.33%). Only one patient (6.67%) had a hemorrhagic conversion following intervention; he later expired. The rate of 90-day favorable outcome (mRS 0–2) was 86.67% (13/15).
Endovascular treatment in the very young population may be carried out with limited complications and attain remarkably high rate of recanalization and favorable outcome. This study supports the role of aggressive management strategies for very young patients with large vessel occlusion.
Details
- Title: Subtitle
- Endovascular stroke intervention in the very young
- Creators
- Mario Zanaty - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USANohra Chalouhi - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USARobert M Starke - Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, USAStavropoula Tjoumakaris - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USADavid Hasan - Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, USAShannon Hann - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USANorman Ajiboye - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USAKenneth C Liu - Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, USARobert H Rosenwasser - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USAPhilip Manasseh - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USAPascal Jabbour - Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.127, pp.15-18
- DOI
- 10.1016/j.clineuro.2014.09.022
- PMID
- 25459237
- NLM abbreviation
- Clin Neurol Neurosurg
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Publisher
- Elsevier B.V
- Language
- English
- Date published
- 12/2014
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040269102771
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