ABSTRACT NUMBER: ESOC2026A1246 INTRAVENOUS THROMBOLYSIS IN PEDIATRIC ACUTE ISCHEMIC STROKE

Abstract Background and aims Intravenous thrombolysis (IVT) is an evidence-based and cornerstone treatment in acute ischemic stroke (AIS) for adult patients. IVT treatment for AIS in pediatric patients (<18 years) lacks this level of evidence. We aimed to investigate safety and outcomes of IVT in AIS pediatric patients (12-17 years) compared to AIS young adult patients (18-24 years). Methods We used the SITS-International Stroke Thrombolysis Registry to identify pediatric and young adult AIS patients treated with IVT. Main outcomes were symptomatic intracerebral hemorrhage (SICH) per SITS-MOST definition, 3-month functional independency (modified Rankin scale score 0-2) and death by 3 months. Propensity score matching (PSM) was used to balance differences between groups. Results We included 76 pediatric and 561 young adult patients. Mean age was 15.5y vs. 21.5y. Slightly higher proportion of males (55% vs 47%, p=0.19), higher median baseline NIHSS score (10 vs 8, p=0.016) and less smoking (11% vs 29%, p=0.002) was present in the pediatric group as compared to the young adult group, with an even balance in endovascular thrombectomy treatment (16% vs 13%, p=0.66) between groups. After PSM, 65 pediatric and 260 young adult patients were included, with a good balance between groups. There were no statistically significant differences in SICH (0% vs 0%), death by 3 months (8% vs 6%), and 3-month mRS 0-2 (79% vs 82%) between groups after PSM. Conclusions We found no statistically significant differences in outcomes after PSM for IVT treated AIS pediatric patients aged 12-17 compared to IVT treated AIS young adults aged 18-24. Conflict of interest Marius Matusevicius: Nothing to disclose. Anand Dixit: Nothing to disclose. Jose Egido: Nothing to disclose. Daniel Strbian: Nothing to disclose. Sabrina Anticoli: Nothing to disclose. Niaz Ahmed: Nothing to disclose.