Abstract
Endovascular thrombectomy (EVT) is the preferred treatment strategy for patients with acute ischemic stroke (AIS). However, clinical outcome and prognosis in patients who undergo EVT in response to AIS with concomitant malignancy have not been fully elucidated. Data of patients with malignancy who underwent EVT at participating institutions between January 2015 and April 2019 were retrospectively analyzed. Patient characteristics, treatment methods, posttreatment strategy, and long-term prognosis were evaluated in 12 patients with prediagnoses of malignancy. Good revascularization (TICI 2b or higher) was achieved in 10 of 12 patients. Among the eight patients who survived more than 2 weeks from onset, four patients showed good clinical outcome [modified Rankin Scale (mRS) <2] at 60 days posttreatment and were able to continue treatment for malignancy. However, seven of eight patients died within a year of EVT (median survival, 83 days) due to progression of malignancy. One-year survival was achieved in only one patient whose etiology of stroke was determined as infectious endocarditis and not Trousseau syndrome. Even after successful revascularization and good short-term clinical outcome, the long-term prognosis after thrombectomy in patients with malignancy was poor. Thrombectomy for concomitant malignancy requires judicious decision, and further studies are necessary to fully elucidate its efficacy.
Highlights
Stroke is a well-known comorbidity in patients suffering from malignancy, and 5–15% of these patients experience cerebrovascular thromboembolic events during their clinical course [1, 2]
Thrombectomy for patients with concomitant malignancy was found in three participating hospitals, and a total of 124 cases of thrombectomy were performed during this period (Hokkaido University Hospital; 9 cases, Hokkaido Medical Center; 41 cases, Teine Keijinkai Hospital 74 cases)
Six patients were prescribed with anticoagulant drug [warfarin or direct oral anticoagulant (DOAC)], and one patient was prescribed with antiplatelet drug before the onset of stroke
Summary
Stroke is a well-known comorbidity in patients suffering from malignancy, and 5–15% of these patients experience cerebrovascular thromboembolic events during their clinical course [1, 2]. The risk of short-term mortality is higher in patients of ischemic stroke with malignancy than in those without concomitant malignancy [3], presumably because stroke leads to lower performance status, which subsequently results in ceasing the treatment of malignancy. The development of endovascular thrombectomy (EVT) is a recent advancement, and numerous randomized clinical trials have proved the efficacy of EVT for the treatment of acute ischemic stroke (AIS) in patients with large vessel occlusion (LVO) [6,7,8,9,10,11]. We assessed the clinical features of patients who underwent EVT for AIS due to concomitant malignancy and their clinical course with a special focus on long-term prognosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
