title: Endovascular stroke intervention in the very young.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Mario
authors.initials: M
authors.lastname: Zanaty
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Nohra
authors.initials: N
authors.lastname: Chalouhi
authors.affiliation: Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, USA.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Starke
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Stavropoula
authors.initials: S
authors.lastname: Tjoumakaris
authors.affiliation: Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, USA.
authors.forename: David
authors.initials: D
authors.lastname: Hasan
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Hann
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Norman
authors.initials: N
authors.lastname: Ajiboye
authors.affiliation: Department of Neurosurgery, University of Virginia School of Medicine, Charlottesville, USA.
authors.forename: Kenneth C
authors.initials: KC
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Rosenwasser
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Manasseh
authors.affiliation: Department of Neurosurgery, Thomas Jefferson University, Philadelphia, USA. Electronic address: pascal.jabbour@jefferson.edu.
authors.forename: Pascal
authors.initials: P
authors.lastname: Jabbour
mesh_terms: D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000601:surgery*; D002548:Cerebral Revascularization / Q000379:methods; D002648:Child; D018450:Disease Progression; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy; D016896:Treatment Outcome; D014218:Triage; D055815:Young Adult
keywords: Endovascular therapy; Large vessel occlusion; Stroke; Young