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New mechanical recanalization devices - the future in pediatric stroke treatment?Grunwald IQ; Walter S; Shamdeen MG; Dautermann A; Roth C; Haass A; Bolar LJ; Reith W; Kuhn AL; Papanagiotou PJ Invasive Cardiol 2010[Feb]; 22 (2): 63-6OBJECTIVE: To evaluate the recanalization rate and clinical outcome in children with acute ischemic stroke following treatment with innovative mechanical thrombectomy devices. PATIENTS AND 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.|Acute Disease[MESH]|Adolescent[MESH]|Angiography, Digital Subtraction[MESH]|Basilar Artery/diagnostic imaging[MESH]|Brain Ischemia/diagnostic imaging/*surgery[MESH]|Carotid Arteries/diagnostic imaging[MESH]|Catheterization[MESH]|Cerebral Angiography[MESH]|Child[MESH]|Female[MESH]|Humans[MESH]|Male[MESH]|Stroke/diagnostic imaging/*surgery[MESH]|Thrombectomy/*instrumentation/methods/trends[MESH]|Vacuum Curettage/instrumentation/methods/trends[MESH] |
