{
  "abstract": "Introduction Acute ischemic stroke in children is a rarity; treatment extrapolates from adult protocols due to ethical constraints in paediatric trials. Mechanical thrombectomy (MT) and intravenous thrombolysis (IVT) are options, but their comparative long-term outcomes remain underexplored in children.Aim of Study To evaluate safety, recanalization efficacy, and functional recovery (mRS 0–2), neurocognitive (PSOM), quality of life (PedsQL), psychosocial (psRRQ), recurrence, and disability-free survival—of MT versus IVT in paediatric ischemic stroke.Method We conducted a PRISMA search of PubMed, Embase, Scopus, Web of Science, Cochrane Library, and Google Scholar (2000–2025). Inclusion: studies in patients <18 y treated with MT or IVT, N ≥ 4, imaging-confirmed stroke, outcomes at ≤1 month, 1–6 months, and >6 months. Random-effects meta-analysis pooled ORs for outcomes; mean differences. Heterogeneity assessed via I². Risk of bias evaluated with RoB 2/NOSAbstract A189 Figure 1PRISMA flow diagram (systematic review only)Results Thirty-two studies (n = 920; MT 610, IVT 310) included; 19 qualified for synthesis >6 mo). MT improved recanalization (84% vs 54%; OR 4.30 [95% CI 2.90–6.40], I² 28%) and functional independence (75% vs 61%; OR 1.95 [1.40–2.70], I² 34%) ( figure 1). Neurocognitive (PSOM 0.9 vs 1.4), quality-of-life (PedsQL 82 vs 75), and psychosocial (psRRQ 78 vs 70) favored MT. Recurrence lower with MT (3.1% vs 6.8%; p = 0.04). Complication rates were comparable (MT 4% vs IVT 4.5%).Abstract A189 Figure 2Stratification of studies in pediatric ischemic stroke systematic reviewConclusion This analysis of robust, peer-reviewed paediatric data demonstrates that MT offers superior recanalization and functional outcomes in stroke, with promising neurocognitive and psychosocial recovery. Multicenter trials will assist establishment of therapeutic guidelines.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "All India Institute of Medical Sciences, New Delhi, India"
      ],
      "name": "Nishita Sharma"
    },
    {
      "affiliations": [
        "Emory University, Atlanta , Georgia, USA"
      ],
      "name": "Daniel Schachter"
    }
  ],
  "title": "A189 Comparative safety and efficacy of mechanical thrombectomy vs intravenous thrombolysis in paediatric ischaemic stroke: a systemic literature review of long-term neurocognitive and psychosocial outcomes",
  "uid": "fc9ca076-7582-50a3-86f1-9f2fd05b3071"
}