Sporns, Peter B., Psychogios, Marios-Nikos, Straeter, Ronald, Hanning, Uta, Minnerup, Jens, Chapot, Rene, Henkes, Hans ORCID: 0000-0002-6534-036X, Henkes, Elina, Grams, Astrid, Dorn, Franziska, Nikoubashman, Omid, Wiesmann, Martin, Bier, Georg, Weber, Anushe, Broocks, Gabriel, Fiehler, Jens, Brehm, Alex, Kaiser, Daniel ORCID: 0000-0001-5258-0025, Yilmaz, Umut, Morotti, Andrea ORCID: 0000-0002-6558-1155, Marik, Wolfgang, Nolz, Richard, Jensen-Kondering, Ulf, Braun, Michael, Schob, Stefan, Beuing, Oliver, Goetz, Friedrich, Trenkler, Johannes, Turowski, Bernd, Mohlembruch, Markus, Wendl, Christina, Schramm, Peter, Musolino, Patricia L. ORCID: 0000-0001-8724-5649, Lee, Sarah, Schlamann, Marc, Radbruch, Alexander ORCID: 0000-0001-6238-6525, Karch, Andre ORCID: 0000-0003-3014-8543, Rubsamen, Nicole, 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). S. E343 - 9. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1526-632X

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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: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Sporns, Peter B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Psychogios, Marios-NikosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Straeter, RonaldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hanning, UtaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Minnerup, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chapot, ReneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Henkes, HansUNSPECIFIEDorcid.org/0000-0002-6534-036XUNSPECIFIED
Henkes, ElinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grams, AstridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dorn, FranziskaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nikoubashman, OmidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiesmann, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bier, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, AnusheUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Broocks, GabrielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fiehler, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brehm, AlexUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaiser, DanielUNSPECIFIEDorcid.org/0000-0001-5258-0025UNSPECIFIED
Yilmaz, UmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morotti, AndreaUNSPECIFIEDorcid.org/0000-0002-6558-1155UNSPECIFIED
Marik, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nolz, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jensen-Kondering, UlfUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Braun, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schob, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Beuing, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goetz, FriedrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trenkler, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Turowski, BerndUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mohlembruch, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wendl, ChristinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schramm, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Musolino, Patricia L.UNSPECIFIEDorcid.org/0000-0001-8724-5649UNSPECIFIED
Lee, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlamann, MarcUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Radbruch, AlexanderUNSPECIFIEDorcid.org/0000-0001-6238-6525UNSPECIFIED
Karch, AndreUNSPECIFIEDorcid.org/0000-0003-3014-8543UNSPECIFIED
Rubsamen, NicoleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wildgruber, MoritzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kemmling, AndreUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-607189
DOI: 10.1212/WNL.0000000000011107
Journal or Publication Title: Neurology
Volume: 96
Number: 3
Page Range: S. E343 - 9
Date: 2021
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1526-632X
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ISCHEMIC-STROKE; THROMBECTOMY; CLASSIFICATIONMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60718

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