Mechanical thrombectomy has become a widely used method for large vessel occlusion in acute ischemic stroke. For young stroke patients (≤ 45 years old), mechanical thrombectomy may also be an efficient method in recanalization of occluded large vessels. However, large vessel occlusion in young stroke usually harbors a specific entity. This case series is to demonstrate the experience of mechanical thrombectomy and possible underlying causes in young stroke patients.
　　Method: Young patients (≤ 45 years old) receiving mechanical thrombectomy for acute ischemic stroke at the authors' institution were identified from 2015 to 2017. The underlying reason for each case was determined by history, imaging studies, laboratory results and clots composition analysis. Initial National Institute of Health Stroke Scales (NIHSS) were determined at our emergency department. The degrees of recanalization were determined using thrombolysis in cerebral infarct (TICI) scores in angiography. Modified Rankin Scale (mRS) scores were determined at 90 days during a follow-up visit.
　　Results: A total of 7 patients were included in this case series. The mean age of the patients in this series was 35 ± 6.0 years. The mean admission NIH Stroke Scale score was 17.5 ± 6 (median 19). Mechanical thrombectomy was performed using the stent retriever in 1 (14%) patient, using thrombosuction in 1 (14%) patient and with combined method in 5 (72%) patients. The rate of successful recanalization TICI score IIb-III was 85.7% (6/7). No patient had intracranial hemorrhage following intervention. Specific or correlated causative underlying diseases were identified in 5 (71%) patients. The rate of 90-day favorable outcome (mRS score 0-2) was 42.8%.
　　Conclusion: Although mechanical thrombectomy provides high recanalization rate in large vessel occlusion without significant hemorrhagic complication, the underlying disease or comorbidity seems an important factor affecting the outcome in young stroke patients.