Back to Search Start Over

Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer.

Authors :
Lee D
Lee DH
Suh DC
Kwon HS
Jeong DE
Kim JG
Lee JS
Kim JS
Kang DW
Jeon SB
Lee EJ
Noh KC
Kwon SU
Source :
Journal of neurology [J Neurol] 2019 Sep; Vol. 266 (9), pp. 2286-2293. Date of Electronic Publication: 2019 Jun 07.
Publication Year :
2019

Abstract

Background and Purpose: This study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic stroke patients with active cancer.<br />Methods: We retrospectively reviewed 253 patients who underwent IAT within 24 h after stroke onset between January 2012 and August 2017. We classified the patients into active cancer (n = 26) and control groups (n = 227) and compared clinical data. Primary outcome was a modified Rankin scale score at 3 months with ordinal logistic regression (shift analysis).<br />Results: Initial National Institutes of Health Stroke Scale (NIHSS) and rate of successful recanalisation did not differ between groups, but the active cancer group showed poor outcomes at 3 months on shift analysis (P = 0.001). The independent predictors of poor prognosis were age [adjusted common odds ratio (aOR) 1.03, 95% confidence interval (CI) 1.01-1.05], baseline NIHSS (aOR 1.14, 95% CI 1.09-1.19), baseline C-reactive protein level (aOR 1.14, 95% CI 1.03-1.25), any cerebral haemorrhage (aOR 1.92, 95% CI 1.21-3.06), and active cancer (aOR 2.35, 95% CI 1.05-5.25). Mortality at 90 days was 30.8% in the cancer group and 8.8% in the control group (P = 0.003).<br />Conclusions: Although baseline characteristics and recanalisation rate after IAT up to 24 h after stroke onset were similar between acute ischaemic stroke patients with active cancer and without any cancer, stroke-related death and short-term outcome were significantly poorer in patients with active cancer than the controls. Post-procedural haemorrhage and active cancer itself were independent predictors of a decrease in functional independence at 3 months.

Details

Language :
English
ISSN :
1432-1459
Volume :
266
Issue :
9
Database :
MEDLINE
Journal :
Journal of neurology
Publication Type :
Academic Journal
Accession number :
31175434
Full Text :
https://doi.org/10.1007/s00415-019-09416-8