Particularidades técnicas del tratamiento endovascular en población adulta y pediátrica con ictus isquémico agudo

Abstract

Endovascular treatment of acute ischemic stroke has had a unique impact on the functional outcomes of large vessel occlusion patients. Advances in techniques, materials and devices have gone hand in hand with the knowledge that has been acquired by healthcare personnel in recent years. Despite these advances, there are various problems, difficulties or setbacks in the endovascular treatment of this pathology. To help resolve some of these dilemmas, we conducted a prospective cohort study in which we planned to analyze the clinical and radiological results of patients with intraprocedural complications, the effect of alteplase combined with mechanical thrombectomy, and the effectiveness of the various third-generation endovascular recanalization devices. Likewise, we analyzed the safety profile of TM in patients under 18 years of age with acute ischemic stroke. Intraprocedural complications, which fortunately occur in a small proportion of patients treated with mechanical thrombectomy are associated with poorer clinical and radiological outcomes both in the short and long term. It seems that the previous infusion of alteplase systemically helps endovascular treatment by reducing the duration of the procedure, increasing the rate of complete recanalization and functional independence. There does not seem to be any difference between the different models of stentrievers on the market. It seems that mechanical thrombectomy is a safe and effective technique in patients under 18 years of age with acute ischemic stroke and clinical-radiological discordance. Especially in teenagers who meet clinical and radiological criteria, similar to those dictated in standardized international treatment guidelines for adults.