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Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis

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Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis. / Bilgin, Cem; Ibrahim, Mohamed; Azzam, Ahmed Y; Ghozy, Sherief; Elswedy, Adam; Kobeissi, Hassan; Sobhi Jabal, Mohamed; Kadirvel, Ramanathan; Boulouis, Grégoire; Naggara, Olivier; Fiehler, Jens; Psychogios, Marios; Lee, Sarah; Wildgruber, Moritz; Kemmling, André; Al-Mufti, Fawaz; Kossorotoff, Manoelle; Sporns, Peter B; Kallmes, David F.

In: CLIN NEURORADIOL, Vol. 33, No. 3, 09.2023, p. 635-644.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Bilgin, C, Ibrahim, M, Azzam, AY, Ghozy, S, Elswedy, A, Kobeissi, H, Sobhi Jabal, M, Kadirvel, R, Boulouis, G, Naggara, O, Fiehler, J, Psychogios, M, Lee, S, Wildgruber, M, Kemmling, A, Al-Mufti, F, Kossorotoff, M, Sporns, PB & Kallmes, DF 2023, 'Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis', CLIN NEURORADIOL, vol. 33, no. 3, pp. 635-644. https://doi.org/10.1007/s00062-022-01246-y

APA

Bilgin, C., Ibrahim, M., Azzam, A. Y., Ghozy, S., Elswedy, A., Kobeissi, H., Sobhi Jabal, M., Kadirvel, R., Boulouis, G., Naggara, O., Fiehler, J., Psychogios, M., Lee, S., Wildgruber, M., Kemmling, A., Al-Mufti, F., Kossorotoff, M., Sporns, P. B., & Kallmes, D. F. (2023). Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis. CLIN NEURORADIOL, 33(3), 635-644. https://doi.org/10.1007/s00062-022-01246-y

Vancouver

Bilgin C, Ibrahim M, Azzam AY, Ghozy S, Elswedy A, Kobeissi H et al. Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis. CLIN NEURORADIOL. 2023 Sep;33(3):635-644. https://doi.org/10.1007/s00062-022-01246-y

Bibtex

@article{0ee3841fd38642babc2faaae4deeaaaa,
title = "Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis",
abstract = "BACKGROUND: Acute intracranial large vessel occlusion (LVO) is an important cause of morbidity and mortality among children; however, unlike in adults, no clinical trial has investigated the benefit of mechanical thrombectomy (MT) in pediatric LVO. Thus, MT remains an off-label procedure for pediatric stroke.PURPOSE: To investigate the efficacy and safety of MT in pediatric LVO.METHODS: A systematic literature search was conducted in Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, and Cochrane Central Register of Clinical Trials databases. Studies reporting safety and efficacy outcomes for endovascular treatment of pediatric LVO were included. Data regarding recanalization, functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality were extracted from the included studies. Functional outcome was assessed with the modified Rankin scale (mRS). A fixed or random-effects model was used to calculate pooled event rates and 95% confidence intervals (CI).RESULTS: In this study 11 studies comprising 215 patients were included. The successful recanalization rate was 90.3% (95% CI = 85.77-95.11%), and complete recanalization was achieved in 52.7% (95% CI = 45.09-61.62%) of the cases. The favorable (mRS = 0-2) and excellent (mRS = 0-1) outcome rates were 83.3% (95% CI = 73.54-94.50%) and 59.5% (95% CI = 44.24-80.06%), respectively. The overall sICH prevalence was 0.59% (95% CI = 0-3.30%) and mortality rate was 3.2% (95% CI = 0.55-7.38%).CONCLUSION: In our meta-analysis, MT demonstrated a promising safety and efficacy profile for pediatric patients, with consistently high efficacy outcomes and low complication rates. Our results support the utilization of MT in pediatric LVOs; however, prospective studies are still needed to further establish the role of pediatric MT as a first-line treatment strategy.",
keywords = "Humans, Child, Brain Ischemia/therapy, Thrombectomy/methods, Stroke/surgery, Intracranial Hemorrhages/etiology, Prospective Studies, Treatment Outcome",
author = "Cem Bilgin and Mohamed Ibrahim and Azzam, {Ahmed Y} and Sherief Ghozy and Adam Elswedy and Hassan Kobeissi and {Sobhi Jabal}, Mohamed and Ramanathan Kadirvel and Gr{\'e}goire Boulouis and Olivier Naggara and Jens Fiehler and Marios Psychogios and Sarah Lee and Moritz Wildgruber and Andr{\'e} Kemmling and Fawaz Al-Mufti and Manoelle Kossorotoff and Sporns, {Peter B} and Kallmes, {David F}",
note = "{\textcopyright} 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.",
year = "2023",
month = sep,
doi = "10.1007/s00062-022-01246-y",
language = "English",
volume = "33",
pages = "635--644",
journal = "CLIN NEURORADIOL",
issn = "1869-1439",
publisher = "Springer Heidelberg",
number = "3",

}

RIS

TY - JOUR

T1 - Mechanical Thrombectomy for Pediatric Large Vessel Occlusions: A Systematic Review and Meta-analysis

AU - Bilgin, Cem

AU - Ibrahim, Mohamed

AU - Azzam, Ahmed Y

AU - Ghozy, Sherief

AU - Elswedy, Adam

AU - Kobeissi, Hassan

AU - Sobhi Jabal, Mohamed

AU - Kadirvel, Ramanathan

AU - Boulouis, Grégoire

AU - Naggara, Olivier

AU - Fiehler, Jens

AU - Psychogios, Marios

AU - Lee, Sarah

AU - Wildgruber, Moritz

AU - Kemmling, André

AU - Al-Mufti, Fawaz

AU - Kossorotoff, Manoelle

AU - Sporns, Peter B

AU - Kallmes, David F

N1 - © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

PY - 2023/9

Y1 - 2023/9

N2 - BACKGROUND: Acute intracranial large vessel occlusion (LVO) is an important cause of morbidity and mortality among children; however, unlike in adults, no clinical trial has investigated the benefit of mechanical thrombectomy (MT) in pediatric LVO. Thus, MT remains an off-label procedure for pediatric stroke.PURPOSE: To investigate the efficacy and safety of MT in pediatric LVO.METHODS: A systematic literature search was conducted in Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, and Cochrane Central Register of Clinical Trials databases. Studies reporting safety and efficacy outcomes for endovascular treatment of pediatric LVO were included. Data regarding recanalization, functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality were extracted from the included studies. Functional outcome was assessed with the modified Rankin scale (mRS). A fixed or random-effects model was used to calculate pooled event rates and 95% confidence intervals (CI).RESULTS: In this study 11 studies comprising 215 patients were included. The successful recanalization rate was 90.3% (95% CI = 85.77-95.11%), and complete recanalization was achieved in 52.7% (95% CI = 45.09-61.62%) of the cases. The favorable (mRS = 0-2) and excellent (mRS = 0-1) outcome rates were 83.3% (95% CI = 73.54-94.50%) and 59.5% (95% CI = 44.24-80.06%), respectively. The overall sICH prevalence was 0.59% (95% CI = 0-3.30%) and mortality rate was 3.2% (95% CI = 0.55-7.38%).CONCLUSION: In our meta-analysis, MT demonstrated a promising safety and efficacy profile for pediatric patients, with consistently high efficacy outcomes and low complication rates. Our results support the utilization of MT in pediatric LVOs; however, prospective studies are still needed to further establish the role of pediatric MT as a first-line treatment strategy.

AB - BACKGROUND: Acute intracranial large vessel occlusion (LVO) is an important cause of morbidity and mortality among children; however, unlike in adults, no clinical trial has investigated the benefit of mechanical thrombectomy (MT) in pediatric LVO. Thus, MT remains an off-label procedure for pediatric stroke.PURPOSE: To investigate the efficacy and safety of MT in pediatric LVO.METHODS: A systematic literature search was conducted in Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, and Cochrane Central Register of Clinical Trials databases. Studies reporting safety and efficacy outcomes for endovascular treatment of pediatric LVO were included. Data regarding recanalization, functional outcome, symptomatic intracranial hemorrhage (sICH), and mortality were extracted from the included studies. Functional outcome was assessed with the modified Rankin scale (mRS). A fixed or random-effects model was used to calculate pooled event rates and 95% confidence intervals (CI).RESULTS: In this study 11 studies comprising 215 patients were included. The successful recanalization rate was 90.3% (95% CI = 85.77-95.11%), and complete recanalization was achieved in 52.7% (95% CI = 45.09-61.62%) of the cases. The favorable (mRS = 0-2) and excellent (mRS = 0-1) outcome rates were 83.3% (95% CI = 73.54-94.50%) and 59.5% (95% CI = 44.24-80.06%), respectively. The overall sICH prevalence was 0.59% (95% CI = 0-3.30%) and mortality rate was 3.2% (95% CI = 0.55-7.38%).CONCLUSION: In our meta-analysis, MT demonstrated a promising safety and efficacy profile for pediatric patients, with consistently high efficacy outcomes and low complication rates. Our results support the utilization of MT in pediatric LVOs; however, prospective studies are still needed to further establish the role of pediatric MT as a first-line treatment strategy.

KW - Humans

KW - Child

KW - Brain Ischemia/therapy

KW - Thrombectomy/methods

KW - Stroke/surgery

KW - Intracranial Hemorrhages/etiology

KW - Prospective Studies

KW - Treatment Outcome

U2 - 10.1007/s00062-022-01246-y

DO - 10.1007/s00062-022-01246-y

M3 - SCORING: Journal article

C2 - 36592199

VL - 33

SP - 635

EP - 644

JO - CLIN NEURORADIOL

JF - CLIN NEURORADIOL

SN - 1869-1439

IS - 3

ER -