{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:58:21Z","timestamp":1793087901026,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi220888-4\"><jats:title>Importance<\/jats:title><jats:p>There is to date limited evidence that revascularization strategies are associated with improved functional outcome in children with acute ischemic stroke (AIS).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-5\"><jats:title>Objectives<\/jats:title><jats:p>To report clinical outcomes and provide estimates of revascularization strategy safety and efficacy profiles of intravenous thrombolysis (IVT) and\/or endovascular treatment (EVT) in children with AIS.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>The KidClot multicenter nationwide cohort study retrospectively collected data of children (neonates excluded) with AIS and recanalization treatment between January 1, 2015, and May 31, 2018. Data analysis was performed from January 1, 2015, to May 31, 2019.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-7\"><jats:title>Exposure<\/jats:title><jats:p>IVT and\/or EVT.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Primary outcome was day 90 favorable outcome (modified Rankin Scale [mRs] 0-2, with 0 indicating no symptoms and 6 indicating death). Secondary end points included 1-year favorable outcome (mRs, 0-2), mortality, and symptomatic intracerebral hemorrhage. Other measures included the Pediatric National Institutes of Health Stroke Scale (pedNIHSS), with pedNIHSS 0 indicating no symptoms, 1 to 4 corresponding to a minor stroke, 5 to 15 corresponding to a mild stroke, greater than 15 to 20: severe stroke, and the adult Alberta Stroke Program Early CT Score (ASPECTS), which provides segmental assessment of the vascular territory, with 1 point deducted from the initial score of 10 for every region involved (from 10 [no lesion] to 0 [maximum lesions]).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-9\"><jats:title>Results<\/jats:title><jats:p>Overall, 68 children were included in 30 centers (IVT [n\u2009=\u200944]; EVT [n\u2009=\u200940]; 44 boys [64.7%]; median [IQR] age, 11 [4-16] years; anterior circulation involvement, 57 [83.8%]). Median (IQR) pedNIHSS score at admission was 13 (7-19), higher in the EVT group at 16 (IQR, 10-20) vs 9 (6-17) in the IVT only group (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u2009.01). Median time from stroke onset to imaging was higher in the EVT group at 3 hours and 7 minutes (IQR, 2 hours and 3 minutes to 6 hours and 24 minutes) vs 2 hours and 39 minutes (IQR, 1 hour and 51 minutes to 4 hours and 13 minutes) (<jats:italic>P<\/jats:italic>\u2009=\u2009.04). Median admission ASPECTS score was 8 (IQR, 6-9). The main stroke etiologies were cardioembolic (21 [30.9%]) and focal cerebral arteriopathy (17 [25.0%]). Median (IQR) time from stroke onset to IVT was 3 hours and 30 minutes (IQR, 2 hours and 33 minutes to 4 hours and 28 minutes). In the EVT group, the rate of postprocedure successful reperfusion (\u2265modified Treatment in Cerebral Infarction 2b) was 80.0% (32 of 40). Persistent proximal arterial stenosis was more frequent in focal cerebral arteriopathy (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u2009.01). Death occurred in 3 patients (4.4%). Median pedNIHSS reduction at 24 hours was 4 (IQR, 0-9) points. Intracerebral hemorrhage occurred in 4 patients and symptomatic intracerebral hemorrhage occurred in 1 patient, all in the EVT group. The median mRS was 2 (IQR, 0-3) at day 90 and 1 (IQR, 0-2) at 1 year, which was not significantly different between EVT and IVT only groups, although different in initial severity.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220888-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>The findings of this cohort study suggest that use of EVT and\/or IVT is safe in children with AIS.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.31343","type":"journal-article","created":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T11:02:56Z","timestamp":1663239776000},"page":"e2231343","source":"Crossref","is-referenced-by-count":44,"title":["Recanalization Treatments for Pediatric Acute Ischemic Stroke in France"],"prefix":"10.1001","volume":"5","author":[{"given":"Mano\u00eblle","family":"Kossorotoff","sequence":"first","affiliation":[{"name":"Assistance publique-H\u00f4pitaux de Paris, French Center for Pediatric Stroke, France"},{"name":"Pediatric Neurology Department, Assistance publique-H\u00f4pitaux de Paris, Inserm, H\u00f4pital Necker-Enfants malades, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basile","family":"Kerleroux","sequence":"additional","affiliation":[{"name":"Pediatric Radiology Department, Assistance publique-H\u00f4pitaux de Paris, H\u00f4pital Necker-Enfants malades, Paris, France"},{"name":"GHU Paris Psychiatrie et Neurosciences, CH Sainte-Anne, Inserm, Universit\u00e9 de Paris Cit\u00e9, Institut de psychiatrie et neurosciences de Paris, Service d'imagerie morphologique et fonctionnelle, UMRS1266, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9goire","family":"Boulouis","sequence":"additional","affiliation":[{"name":"Assistance publique-H\u00f4pitaux de Paris, French Center for Pediatric Stroke, France"},{"name":"Pediatric Radiology Department, Assistance publique-H\u00f4pitaux de Paris, H\u00f4pital Necker-Enfants malades, Paris, France"},{"name":"Neuroradiology, Tours University, CHRU Bretonneau, Tours, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9atrice","family":"Husson","sequence":"additional","affiliation":[{"name":"Assistance publique-H\u00f4pitaux de Paris, French Center for Pediatric Stroke, France"},{"name":"Pediatric Radiology Department, Assistance publique-H\u00f4pitaux de Paris, Universit\u00e9 de Paris-Saclay, H\u00f4pital Bic\u00eatre, le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Tran Dong","sequence":"additional","affiliation":[{"name":"Assistance publique-H\u00f4pitaux de Paris, French Center for Pediatric Stroke, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Eugene","sequence":"additional","affiliation":[{"name":"Neuroradiology, Rennes University, CHU de Rennes, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Damaj","sequence":"additional","affiliation":[{"name":"Pediatric Department, Rennes University, CHU de Rennes, Rennes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustin","family":"Ozanne","sequence":"additional","affiliation":[{"name":"Assistance publique-H\u00f4pitaux de Paris, French Center for Pediatric Stroke, France"},{"name":"Department of Interventional Neuroradiology Neuro Brain Vascular Center, Assistance publique-H\u00f4pitaux de Paris, Paris-Saclay University, H\u00f4pital Bic\u00eatre, le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Bellesme","sequence":"additional","affiliation":[{"name":"Pediatric Stroke Unit and Pediatric Neurology Department, Assistance publique-H\u00f4pitaux de Paris, Paris-Saclay University, H\u00f4pital Bic\u00eatre, le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Rolland","sequence":"additional","affiliation":[{"name":"Neurology Department, Nantes University, CHU de Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romain","family":"Bourcier","sequence":"additional","affiliation":[{"name":"Pediatric Department, Nantes University, CHU de Nantes, Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Triquenot-Bagan","sequence":"additional","affiliation":[{"name":"Neurology Department, Rouen University, CHU de Rouen, Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaultier","family":"Marnat","sequence":"additional","affiliation":[{"name":"Neuroradiology Department, Bordeaux University, CHU de Bordeaux, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Philippe","family":"Neau","sequence":"additional","affiliation":[{"name":"Neurology Department. 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