Standardizing Global Pediatric Stroke Pathways: Insights From a Global Survey Conducted by the Society of Neurointerventional Surgery Pediatric Special Interest Group

BACKGROUND: To evaluate global stroke pathways in pediatric acute ischemic stroke care, including availability of personnel, imaging practices, hyperacute therapies available, and institutional resources. METHODS: A 25-question survey designed by the Society of Neurointerventional Surgery Pediatric Special Interest Group was distributed internationally via pediatric and neurointerventional societies. The survey collected data on institutional settings, stroke team composition, imaging protocols, use of artificial intelligence, and access to thrombectomy and thrombolysis. Responses from 103 stroke care providers were analyzed using descriptive statistics. Participation was voluntary and anonymous, and >1 respondent from the same institution was permitted. RESULTS: Ninety-one of 103 respondents (88%) reported managing pediatric acute ischemic stroke. However, only 65% offered both intravenous thrombolysis and thrombectomy. Computed tomography and computed tomography angiography were the most commonly used first-line imaging modality (34%), whereas perfusion imaging and artificial intelligence tools were underutilized. Pediatric neurologists were the most common decision-makers for thrombolysis (38%). Posterior circulation thrombectomy was widely unavailable (offered at only 45% of centers). CONCLUSIONS: Survey results revealed considerable variability in pediatric acute ischemic stroke pathways globally and a lack of standardization in treatment. Disparities in access to imaging, hyperacute therapies, and trained personnel underscore the need for standardization, international collaboration, and the creation of systems utilizing available resources to improve pediatric stroke care.

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Publication Details

Journal
Stroke Vascular and Interventional Neurology
Published
2026-06-12
DOI
https://doi.org/10.1161/svin.126.002317
Primary Topic
Blood Coagulation and Thrombosis Mechanisms
Type
article
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article

Standardizing Global Pediatric Stroke Pathways: Insights From a Global Survey Conducted by the Society of Neurointerventional Surgery Pediatric Special Interest Group

Carmen Parra-Fariñas, Monica S. Pearl, Ali Shaibani, Santiago Ortega‐Gutiérrez et al.
Stroke Vascular and Interventional Neurology
Blood Coagulation and Thrombosis Mechanisms
article

Standardizing Global Pediatric Stroke Pathways: Insights From a Global Survey Conducted by the Society of Neurointerventional Surgery Pediatric Special Interest Group

Carmen Parra-Fariñas, Monica S. Pearl, Ali Shaibani, Santiago Ortega‐Gutiérrez, Prakash Muthusami, Alfred P. See, Johanna T Fifi, Neeraj Chaudhary, Alhamza R Al‐Bayati, Peter Kan, Darren B. Orbach, Aditya S. Pandey, Steven W. Hetts, Mesha Martinez, Michael T. Froehler, Daniel L. Cooke, G NESBIT, Aarón Rodríguez-Calienes, Karen Chen, Adam Rennie, Lucas Elijovich, Todd Abruzzo, Joseph J. Gemmete
article en

Abstract

BACKGROUND: To evaluate global stroke pathways in pediatric acute ischemic stroke care, including availability of personnel, imaging practices, hyperacute therapies available, and institutional resources. METHODS: A 25-question survey designed by the Society of Neurointerventional Surgery Pediatric Special Interest Group was distributed internationally via pediatric and neurointerventional societies. The survey collected data on institutional settings, stroke team composition, imaging protocols, use of artificial intelligence, and access to thrombectomy and thrombolysis. Responses from 103 stroke care providers were analyzed using descriptive statistics. Participation was voluntary and anonymous, and >1 respondent from the same institution was permitted. RESULTS: Ninety-one of 103 respondents (88%) reported managing pediatric acute ischemic stroke. However, only 65% offered both intravenous thrombolysis and thrombectomy. Computed tomography and computed tomography angiography were the most commonly used first-line imaging modality (34%), whereas perfusion imaging and artificial intelligence tools were underutilized. Pediatric neurologists were the most common decision-makers for thrombolysis (38%). Posterior circulation thrombectomy was widely unavailable (offered at only 45% of centers). CONCLUSIONS: Survey results revealed considerable variability in pediatric acute ischemic stroke pathways globally and a lack of standardization in treatment. Disparities in access to imaging, hyperacute therapies, and trained personnel underscore the need for standardization, international collaboration, and the creation of systems utilizing available resources to improve pediatric stroke care.

Stroke Vascular and Interventional Neurology
Boston Children's Hospital (US), Oregon Health & Science University (US), University of California, San Francisco (US), University of Michigan (US), Great Ormond Street Hospital (GB), University Health System (US), Paradise Valley Community College (US), Hospital for Sick Children (CA), University of Iowa Hospitals and Clinics (US), University of California System (US), National Hospital (IN), Jackson Health System (US), Neurogen Brain & Spine Institute (IN), Semmes Murphey Foundation (US), Michigan Medicine (US), Lurie Children's Hospital (US), University of Pittsburgh Medical Center (US), Texas Children's Hospital (US), Boston Children's Museum (US), University College London (GB), The University of Texas Medical Branch at Galveston (US), Vanderbilt University Medical Center (US), Icahn School of Medicine at Mount Sinai (US)
Partnerships for the goals
Openalex Percentile: Top 6%
Blood Coagulation and Thrombosis Mechanisms
DOIOpen Access PDFOpenAlex
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