Although younger adults have been shown to have better functional outcomes after mechanical thrombectomy (MT) for acute ischemic stroke (AIS), the significance of this relationship in the adolescent and young adult (AYA) population is not well defined given its undefined rarity. Correspondingly, the goal of this study was to determine the prognostic significance of age in this specific demographic following MT for large-vessel occlusions.

A prospectively maintained international multi-institutional database, STAR (Stroke Thrombectomy and Aneurysm Registry), was reviewed for all patients aged 12–18 (adolescent) and 19–25 (young adult) years. Parameters were compared using chi-square and t-test analyses, and associations were interrogated using regression analyses.

Of 7192 patients in the registry, 41 (0.6%) satisfied all criteria, with a mean age of 19.7 ± 3.3 years. The majority were male (59%) and young adults (61%) versus adolescents (39%). The median prestroke modified Rankin Scale (mRS) score was 0 (range 0–2). Strokes were most common in the anterior circulation (88%), with the middle cerebral artery being the most common vessel (59%). The mean onset-to–groin puncture and groin puncture–to-reperfusion times were 327 ± 229 and 52 ± 42 minutes, respectively. The mean number of passes was 2.2 ± 1.2, with 61% of the cohort achieving successful reperfusion. There were only 3 (7%) cases of reocclusion. The median mRS score at 90 days was 2 (range 0–6). Between the adolescent and young adult subgroups, the median mRS score at last follow-up was statistically lower in the adolescent subgroup (1 vs 2, p = 0.03), and older age was significantly associated with a higher mRS at 90 days (coefficient 0.33, p < 0.01).

Although rare, MT for AIS in the AYA demographic is both safe and effective. Even within this relatively young demographic, age remains significantly associated with improved functional outcomes. The implication of age-dependent stroke outcomes after MT within the AYA demographic needs greater validation to develop effective age-specific protocols for long-term care across both pediatric and adult centers.

尽管年轻人在急性缺血性卒中（AIS）机械取栓（MT）后已被证明具有更好的功能结果，但由于其罕见性未明确，这种关系在青少年和年轻成人（AYA）人群中的意义尚不明确。相应地，本研究的目标是确定年龄对于大血管闭塞 MT 后特定人群的预后意义。

对所有 12-18 岁（青少年）和 19-25 岁（青年）患者的前瞻性维护的国际多机构数据库 STAR（中风血栓切除术和动脉瘤登记处）进行了审查。使用卡方和 t 检验分析比较参数，并使用回归分析询问相关性。

在登记的 7192 名患者中，41 名 (0.6%) 满足所有标准，平均年龄为 19.7 ± 3.3 岁。大多数是男性（59%）和年轻人（61%），而青少年（39%）。中风前改良Rankin量表（mRS）评分中位数为0（范围0-2）。中风在前循环中最常见（88%），其中大脑中动脉是最常见的血管（59%）。平均开始腹股沟穿刺和腹股沟穿刺再灌注时间分别为 327 ± 229 和 52 ± 42 分钟。平均通过次数为 2.2 ± 1.2，其中 61% 的队列成功实现再灌注。仅 3 例（7%）发生再闭塞。 90 天时的中位 mRS 评分为 2（范围 0-6）。在青少年和年轻成人亚组之间，青少年亚组最后一次随访时的中位 mRS 评分在统计上较低（1 vs 2，p = 0.03），并且年龄较大与 90 天时较高的 mRS 显着相关（系数 0.33） ，p < 0.01）。

尽管很少见，但 MT 在 AYA 人群中治疗 AIS 既安全又有效。即使在这个相对年轻的人群中，年龄仍然与功能结果的改善显着相关。 AYA 人群中 MT 后年龄依赖性卒中结果的影响需要进一步验证，以制定有效的针对儿科和成人中心长期护理的特定年龄方案。