Although mechanical thrombectomy (MT) is the standard of care for anterior circulation acute large-vessel occlusion (LVO), it is not known whether MT benefits patients with National Institutes of Health Stroke Scale scores less than 6. Goyal and colleagues evaluated 364 patients with mild deficits and acute LVO treated with MT or best medical management in a retrospective pooled multicenter study over a 5-year period. The patients treated with MT experienced higher odds of asymptomatic intracerebral hemorrhage (ICH) and lower rates of 3-month functional independence compared with patients treated with best medical management. In a meta-analysis that included 843 patients from 4 studies, MT was associated with higher odds of symptomatic ICH, but no other differences, suggesting a clinical trial in this patient population is warranted.

Randomized clinical trials show efficacy of endovascular recanalization for stroke treatment in adults, but it is not clear whether these results can be applied to pediatric patients with stroke with large-vessel occlusion. Sporns and coauthors found that endovascular recanalization appeared to be safe with positive interventional and neurologic outcomes in this pediatric population. The study findings showed that the rate of recanalization, complications, and neurologic outcomes were comparable with those in adult trials and therefore support endovascular recanalization in children with acute, large-vessel occlusion. Editorial perspective is provided by Fox and Dlamini.

Editorial

尽管机械血栓切除术（MT）是前循环急性大血管闭塞（LVO）的治疗标准，但尚不清楚MT是否使美国国立卫生研究院卒中量表评分低于6的患者受益。Goyal及其同事评估了364例在一项为期5年的回顾性汇总多中心研究中，接受MT或最佳药物治疗的轻度缺陷和急性LVO。与接受最佳药物治疗的患者相比，接受MT治疗的患者出现无症状性脑出血（ICH）的几率更高，并且3个月的功能独立性发生率较低。在一项包括来自4个研究的843例患者的荟萃分析中，MT与有症状ICH的可能性更高相关，但没有其他差异，这表明该患者人群有必要进行临床试验。

随机临床试验显示了血管内再通技术在成人中风治疗中的功效，但尚不清楚这些结果是否可应用于有大血管阻塞的中风儿科患者。Sporns和合著者发现，在该儿科人群中，血管内再通似乎是安全的，具有积极的介入和神经学预后。研究结果表明，再通率，并发症和神经系统结果与成人试验相当，因此支持急性大血管闭塞儿童的血管内再通。Fox和Dlamini提供了编辑观点。

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