Endovascular stroke intervention in the very young

• Data on stroke in the very young is lacking and insufficient.
• Endovascular therapy can achieve a high recanalization rate and favorable outcome.
• Endovascular therapy can have limited complications.
• We advise aggressive management for very young patients.

Object: This study aims to evaluate the use of endovascular therapy to treat very young (≤35 years) patients with acute ischemic stroke from large vessel occlusion.MethodsWe identified from a prospectively maintained database young patients (≤35 years) undergoing endovascular intervention for AIS at two cerebrovascular referral centers. The study only included patients with a confirmed large vessel occlusion. Modified Rankin scale (mRS) scores were determined at 90 days during a follow-up visit.ResultsA total of 15 patients met the inclusion criteria. Mean age was 27.93 years ± 6.75 years (range: 9–35 years). On admission, the mean NIHSS score was 14.07 ± 9.16. Mechanical thrombectomy was performed using the Solitaire FR device in 4 of 15 (26.67%) patients and the Merci/Penumbra systems in 11 (73.33%) patients. Successful recanalization (TICI 2–3) was achieved in all but one patient (14/15; 93.33%). Only one patient (6.67%) had a hemorrhagic conversion following intervention; he later expired. The rate of 90-day favorable outcome (mRS 0–2) was 86.67% (13/15).ConclusionEndovascular treatment in the very young population may be carried out with limited complications and attain remarkably high rate of recanalization and favorable outcome. This study supports the role of aggressive management strategies for very young patients with large vessel occlusion.