Intravenous thrombolysis followed by intra-arterial thrombolysis and mechanical thrombectomy for the treatment of pediatric ischemic stroke.
Experience with systemic or selective local administration of thrombolytic agents in pediatric ischemic stroke is limited to sporadic case reports, since patients of age less than 18 years were systematically excluded from randomised controlled trials. We report a case of childhood IS attributable to the terminal internal carotid artery occlusion that was treated successfully with mechanical thrombectomy which followed unsuccessful attempts to recanalize the artery with intravenous and intra-arterial thrombolytics. Combined systemic and intra-arterial thrombolysis followed by mechanical thrombectomy can be feasible and may be considered as means of achieving reperfusion in pediatric ischemic stroke patients with persisting arterial occlusion.
Tsivgoulis
Georgios
G
Comprehensive Stroke Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA. tsivgoulisgiorg@yahoo.gr
Horton
Joseph A
JA
Ness
Jayne M
JM
Patterson
Damon
D
Brethour
Mary
M
Abanses
Juan Carlos
JC
Alexandrov
Andrei V
AV
D000792:Angiography / Q000379:methods; D002533:Cerebral Angiography / Q000379:methods; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D004333:Drug Administration Routes; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D020521:Stroke / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods
D005343:Fibrinolytic Agents