LAUSR

Childhood arterial ischemic stroke is a rare clinical event but has a potentially severe outcome with long-term social and financial impact. The TIPS trial (Thrombolysis in Pediatric Stroke), a safety and dosefinding study of intravenous tissue-type plasminogen activator (tPA) in children, was closed early due to lack of participant accrual.1 Regarding the use of mechanical thrombectomy (MT), after several small case series,2 the Save ChildS study recently provided multicentre evidence for the use of MT in children with large vessel occlusion arterial ischemic stroke.3 In this study, the rate of recanalization and adverse events was comparable to randomized controlled trials in adults, and neurological outcomes of the children were generally favourable. However, current guidelines still consider supportive medical management specific to the underlying cause as first-line therapy,4 and there are several unanswered questions regarding the use of MT in pediatric patients.