New mechanical recanalization devices - the future in pediatric stroke treatment?
OBJECTIVE
To evaluate the recanalization rate and clinical outcome in children with acute ischemic stroke following treatment with innovative mechanical thrombectomy devices.


METHODS
Three subjects aged 7-16 years presenting with acute cerebral vascular occlusions (thrombolysis in myocardial infarction [TIMI] 0) were treated with either the Penumbra System, operating on an aspiration platform, or the Phenox clot retriever device, a flexible wire compound with perpendicularly-oriented polyamid microfilaments. Target vessels were the internal carotid artery, the middle cerebral artery and the basilar artery.


RESULTS
Successful recanalization (TIMI 3) was attained in all cases. No device-related complications or intracranial hemorrhage occurred. Follow up was conducted for up to 30 days. A 10- to 26-point improvement in the National Institutes of Health Stroke Scale (NIHSS) score was achieved.


CONCLUSIONS
Mechanical thrombectomy devices possess a dual advantage whereby they can achieve instant recanalization as well as minimize the number of bleeds that customarily accompany intravenous and intra-arterial therapy. These new devices could contribute greatly to treatment decisions in a field not yet clearly defined by current guidelines.
Grunwald
Iris Quasar
IQ
Acute Vascular Imaging Centre, Biomedical Research Centre, Oxford OX3 9DU, United Kingdom. i.grunwald@web.de
Walter
Silke
S
Shamdeen
Mohammed Ghiath
MG
Dautermann
Anna
A
Roth
Christian
C
Haass
Anton
A
Bolar
Linet Jenifa
LJ
Reith
Wolfgang
W
Kühn
Anna Luisa
AL
Papanagiotou
Panagiotis
P
D000208:Acute Disease; D000293:Adolescent; D015901:Angiography, Digital Subtraction; D001488:Basilar Artery / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002404:Catheterization; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging / Q000601:surgery*; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods / Q000639:trends; D014619:Vacuum Curettage / Q000295:instrumentation / Q000379:methods / Q000639:trends