Abstract
Mechanical thrombectomy (MT) in pediatric stroke is supported by studies in adults,
but there is controversy regarding younger patients. The main growth of intracranial
vessels occurs up to 2 years when there can be more difficulties in MT.
Description of the MT performed in a 2-month-old patient—the youngest infant published
to date. We also review the literature on MT for stroke in infants.
A 2-month-old patient presented with an awakening stroke secondary to an occlusion
of the M1 segment of the left middle cerebral artery. A successful MT was performed
with an aspiration device without clinically significant complications. An etiological
study was completed, and neuroimaging showed focal cerebral arteriopathy. The 3-month
outcome was excellent: the pediatric modified Rankin score was 0.
Including this case, MT for acute stroke has been reported in only 10 infants. MT
was successful in 90%, mostly using adult conventional stent retrievers. There were
complications only in patients with mechanical circulatory support (MCS) devices;
three patients died due to hemorrhagic transformation after MT and one patient died
due to recurrent ischemic stroke.
MT seems effective and safe in infants similarly to other pediatric ages. In children
under 2 years of age, the presence of comorbidities requiring MCS devices is the main
factor underlying poor prognosis.
Keywords
mechanical thrombectomy - infants - acute stroke - pediatric stroke
