Sporns Peter B, Kemmling André, Lee Sarah, Fullerton Heather, Kunz Wolfgang G, Wilson Jenny L, Mackay Mark T, Steinlin Maja, Fiehler Jens, Psychogios Marios, Wildgruber Moritz
Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland.
Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Neurol. 2021 Sep 3;12:736092. doi: 10.3389/fneur.2021.736092. eCollection 2021.
Early evidence for the benefit of mechanical thrombectomy (MT) in pediatric patients with intracranial large vessel occlusion has been shown in previous retrospective cohorts. Higher-level evidence is needed to overcome the limitations of these studies such as the lack of a control group and the retrospective design. Randomized trials will very likely not be feasible, and several open questions remain, for example, the impact of arteriopathic etiologies or a possible lower age limit for MT. Save ChildS Pro therefore aims to demonstrate the safety and effectiveness of MT in pediatric patients compared to the best medical management and intravenous thrombolysis. Save ChildS Pro is designed as a worldwide multicenter prospective registry comparing the safety and effectiveness of MT to the best medical care alone in the treatment of pediatric arterial ischemic stroke (AIS). It will include pediatric patients (<18 years) with symptomatic acute intracranial arterial occlusion who underwent either MT or best medical treatment including intravenous thrombolysis. The primary endpoint of Save ChildS Pro is the modified Rankin Scale score at 90 days post-stroke. Secondary endpoints will comprise the decrease of the Pediatric National Institutes of Health Stroke Scale score from admission to discharge and rate of complications. Save ChildS Pro aims to provide high-level evidence for MT for pediatric patients with AIS, thereby improving functional outcome and quality of life and reducing the individual, societal, and economic burden of death and disability resulting from pediatric stroke. Save ChildS Pro is registered at the German Clinical Trials Registry (DRKS; identifier: DRKS00018960).
先前的回顾性队列研究已显示了机械取栓术(MT)对患有颅内大血管闭塞的儿科患者有益的早期证据。需要更高级别的证据来克服这些研究的局限性,例如缺乏对照组和回顾性设计。随机试验很可能不可行,并且仍存在几个未解决的问题,例如动脉病变病因的影响或MT可能的更低年龄限制。因此,“拯救儿童卒中计划(Save ChildS Pro)”旨在证明与最佳药物治疗和静脉溶栓相比,MT在儿科患者中的安全性和有效性。“拯救儿童卒中计划”被设计为一项全球多中心前瞻性注册研究,比较MT与单纯最佳药物治疗在治疗小儿动脉缺血性卒中(AIS)方面的安全性和有效性。它将纳入患有症状性急性颅内动脉闭塞且接受了MT或包括静脉溶栓在内的最佳药物治疗的儿科患者(<18岁)。“拯救儿童卒中计划”的主要终点是卒中后90天的改良Rankin量表评分。次要终点将包括从入院到出院时小儿国立卫生研究院卒中量表评分的降低以及并发症发生率。“拯救儿童卒中计划”旨在为患有AIS的儿科患者的MT提供高级别证据,从而改善功能结局和生活质量,并减轻小儿卒中导致的个人、社会以及死亡和残疾的经济负担。“拯救儿童卒中计划”已在德国临床试验注册中心(DRKS;标识符:DRKS00018960)注册。