Intravenous tPA and Endovascular Thrombectomy Utilization in Pediatric Acute Ischemic Stroke

International Journal of Stroke : Official Journal of the International Stroke Society

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The authors of this study examined risk factors, thrombolysis, thrombectomy, and outcomes in 9109 pediatric patients presenting with acute ischemic stroke. Risk factors included epilepsy (19.59%), atrial septal defect (11.76%), sickle cell disease (8.63%), and moyamoya disease (5.41%). Of the patients, 119 (1.30%) underwent intravenous thrombolysis, 256 (2.82%) underwent mechanical thrombectomy, and 69 (0.75%) received both thrombolysis and thrombectomy. Each of these treatment groups had a significantly higher risk of hemorrhagic conversion (5.85%, 8.42%, 7.01%, respectively) compared with the group who received no treatment (1.03%).

Patients undergoing interventions had higher morbidity and mortality than patients who did not receive treatment, suggesting a strong need for large clinical trials to determine safety and efficacy of stroke treatments in the pediatric population.