1. Does Device Selection Impact Recanalization Rate and Neurological Outcome?: An Analysis of the Save ChildS Study
- Author
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Johannes Trenkler, Jens Minnerup, Bernd Turowski, Nicole Rübsamen, Elina Henkes, Heinz Wiendl, Daniel Kaiser, Astrid E. Grams, Omid Nikoubashman, Walter Heindel, Sarah Lee, Markus A Möhlenbruch, Alex Brehm, Franziska Dorn, Stefan Schob, Alexander Radbruch, Uta Hanning, Gabriel Broocks, Oliver Beuing, Friedrich Goetz, Bernd Schmitz, Peter Schramm, Ronald Straeter, Moritz Wildgruber, Georg Bier, Marios Psychogios, Marc Schlamann, Andrea Morotti, Peter B. Sporns, Christina Wendl, Wolfgang Marik, Martin Wiesmann, Umut Yilmaz, Richard Nolz, René Chapot, Jens Fiehler, André Kemmling, Ulf Jensen-Kondering, Anushe Weber, Patricia L. Musolino, André Karch, and Hans Henkes
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Medizin ,030204 cardiovascular system & hematology ,Brain Ischemia ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Modified Rankin Scale ,medicine ,Pediatric stroke ,Humans ,Child ,Stroke ,Retrospective Studies ,Thrombectomy ,Advanced and Specialized Nursing ,Cerebral Revascularization ,Cerebral infarction ,business.industry ,Incidence (epidemiology) ,Endovascular Procedures ,Stent ,Infant ,medicine.disease ,3. Good health ,Surgery ,Treatment Outcome ,Child, Preschool ,Female ,Stents ,Neurology (clinical) ,Nervous System Diseases ,Cardiology and Cardiovascular Medicine ,Complication ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Background and Purpose— The recent Save ChildS study provides multicenter evidence for the use of mechanical thrombectomy in children with large vessel occlusion arterial ischemic stroke. However, device selection for thrombectomy may influence rates of recanalization, complications, and neurological outcomes, especially in pediatric patients of different ages. We, therefore, performed additional analyses of the Save ChildS data to investigate a possible association of different thrombectomy techniques and devices with angiographic and clinical outcome parameters. Methods— The Save ChildS cohort study (January 2000–December 2018) analyzed data from 27 European and United States stroke centers and included all pediatric patients ( Results— Seventy-three patients with a median age of 11.3 years were included. Currently available stent retrievers were used in 59 patients (80.8%), of which 4×20 mm (width×length) was the most frequently chosen size (36 patients =61%). A first-line ADAPT approach was used in 7 patients (9.6%), and 7 patients (9.6%) were treated with first-generation thrombectomy devices. In this study, a first-line ADAPT approach was neither associated with the rate of successful recanalization (ADAPT 85.7% versus 87.5% No ADAPT) nor with the complication rate or the neurological outcome. Moreover, there were no associations of stent retriever sizes with rates of recanalization, complication rates, or outcome parameters. Conclusions— Our study suggests that neurological outcomes are generally good regardless of any specific device selection and suggests that it is important to offer thrombectomy in eligible children regardless of technique or device selection. Registration— URL: https://www.drks.de/ ; Unique identifier: DRKS00016528.
- Published
- 2020