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Purpose <p>This meta-analysis aimed to evaluate the clinical outcomes and safety of mechanical thrombectomy (MT) in pediatric acute ischemic stroke (AIS).</p> Methods <p>Systematic search of PubMed, Embase and Cochrane Library identified studies on MT in children (≤ 18 years) with AIS. Data on baseline characteristics, procedural details and clinical outcomes, including favorable functional outcome (modified Rankin Scale [mRS] 0–2), National Institutes of Health Stroke Scale (NIHSS) reduction, Pediatric Stroke Outcome Measure (PSOM), symptomatic intracranial hemorrhage (sICH) and mortality were extracted. A single-arm meta-analysis was performed to estimate pooled rates.</p> Results <p>25 studies, encompassing 885 patients (mean age of included cohorts: 10.2–18 years), were included. The pooled favorable functional outcome was 80% (95% CI, 70%–88%), while the poor functional outcome was 14% (95% CI: 5%-26%). Mean NIHSS reduction was 8.07 (95% CI, 5.93–10.22), PedNIHSS decrease was 14.64 (95% CI: 12.04 to 17.24), and pooled mean PSOM score at follow-up was 1.02 (95% CI, 0.48–1.55). sICH was 2% (95% CI, 0–5%), need for decompressive hemicraniectomy was 7% (95% CI: 2%–14%) and overall mortality was 4% (95% CI, 1%–8%). Successful recanalization was 88% (95% CI: 81%–95%) and no reperfusion and re-occlusion were both 3% (95% CI: 0%–7%).</p> Conclusion <p>MT appears to be a promising and safe treatment option for pediatric AIS, demonstrating high rates of favorable functional outcomes and low mortality/sICH. However, significant heterogeneity among studies highlights the need for further high-quality, standardized research to optimize patient selection and define its effectiveness.</p>

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Safety of mechanical thrombectomy in pediatric acute ischemic stroke: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Lucca Tamara Alves Carretta,
  • Ocilio Ribeiro Gonçalves,
  • Lucas Copolillo Faria,
  • Rafael Torres Fonseca dos Santos,
  • Mariana Lee Han,
  • Wagner Rios-Garcia,
  • Filipe Virgilio Ribeiro,
  • Marianna Leite,
  • Yasmin Picanço Silva,
  • Adil Ahmed,
  • Nicole Baptista de Oliveira,
  • Ahmet Günkan,
  • Pascal Jabbour

摘要

Purpose

This meta-analysis aimed to evaluate the clinical outcomes and safety of mechanical thrombectomy (MT) in pediatric acute ischemic stroke (AIS).

Methods

Systematic search of PubMed, Embase and Cochrane Library identified studies on MT in children (≤ 18 years) with AIS. Data on baseline characteristics, procedural details and clinical outcomes, including favorable functional outcome (modified Rankin Scale [mRS] 0–2), National Institutes of Health Stroke Scale (NIHSS) reduction, Pediatric Stroke Outcome Measure (PSOM), symptomatic intracranial hemorrhage (sICH) and mortality were extracted. A single-arm meta-analysis was performed to estimate pooled rates.

Results

25 studies, encompassing 885 patients (mean age of included cohorts: 10.2–18 years), were included. The pooled favorable functional outcome was 80% (95% CI, 70%–88%), while the poor functional outcome was 14% (95% CI: 5%-26%). Mean NIHSS reduction was 8.07 (95% CI, 5.93–10.22), PedNIHSS decrease was 14.64 (95% CI: 12.04 to 17.24), and pooled mean PSOM score at follow-up was 1.02 (95% CI, 0.48–1.55). sICH was 2% (95% CI, 0–5%), need for decompressive hemicraniectomy was 7% (95% CI: 2%–14%) and overall mortality was 4% (95% CI, 1%–8%). Successful recanalization was 88% (95% CI: 81%–95%) and no reperfusion and re-occlusion were both 3% (95% CI: 0%–7%).

Conclusion

MT appears to be a promising and safe treatment option for pediatric AIS, demonstrating high rates of favorable functional outcomes and low mortality/sICH. However, significant heterogeneity among studies highlights the need for further high-quality, standardized research to optimize patient selection and define its effectiveness.