Endovascular stroke intervention in the very young

Mario Zanaty; Nohra Chalouhi; Robert M. Starke; Stavropoula Tjoumakaris; David Hasan; Shannon Hann; Norman Ajiboye; Kenneth C. Liu; Robert H. Rosenwasser; Philip Manasseh; Pascal Jabbour

doi:10.1016/j.clineuro.2014.09.022

Endovascular stroke intervention in the very young

Mario Zanaty, Nohra Chalouhi, Robert M. Starke, Stavropoula Tjoumakaris, David Hasan, Shannon Hann, Norman Ajiboye, Kenneth C. Liu, Robert H. Rosenwasser, Philip Manasseh, Pascal Jabbour

Department of Neurosurgery

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Object: 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).

Conclusion 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.

Original language	English (US)
Pages (from-to)	15-18
Number of pages	4
Journal	Clinical Neurology and Neurosurgery
Volume	127
DOIs	https://doi.org/10.1016/j.clineuro.2014.09.022
State	Published - Oct 3 2014

All Science Journal Classification (ASJC) codes

Surgery
Clinical Neurology

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10.1016/j.clineuro.2014.09.022

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title = "Endovascular stroke intervention in the very young",

abstract = "Object: 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).Conclusion 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.",

author = "Mario Zanaty and Nohra Chalouhi and Starke, {Robert M.} and Stavropoula Tjoumakaris and David Hasan and Shannon Hann and Norman Ajiboye and Liu, {Kenneth C.} and Rosenwasser, {Robert H.} and Philip Manasseh and Pascal Jabbour",

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doi = "10.1016/j.clineuro.2014.09.022",

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T1 - Endovascular stroke intervention in the very young

AU - Zanaty, Mario

AU - Chalouhi, Nohra

AU - Starke, Robert M.

AU - Tjoumakaris, Stavropoula

AU - Hasan, David

AU - Hann, Shannon

AU - Ajiboye, Norman

AU - Liu, Kenneth C.

AU - Rosenwasser, Robert H.

AU - Manasseh, Philip

AU - Jabbour, Pascal

PY - 2014/10/3

Y1 - 2014/10/3

N2 - Object: 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).Conclusion 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.

AB - Object: 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).Conclusion 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.

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JO - Clinical Neurology and Neurosurgery

JF - Clinical Neurology and Neurosurgery

ER -

Endovascular stroke intervention in the very young

Abstract

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