Treatment of acute ischemic stroke in patients with active malignancy: insight from a comprehensive stroke center.

Autor:	Chae WH; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Vössing A; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Li Y; Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany., Deuschl C; Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany., Milles LS; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Kühne Escolà J; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Hüsing A; Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany., Darkwah Oppong M; Department of Neurosurgery and Spine Surgery and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Dammann P; Department of Neurosurgery and Spine Surgery and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Glas M; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Forsting M; Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany., Kleinschnitz C; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Köhrmann M; Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany., Frank B; Department of Neurology, University Hospital Essen, Hufelandstraße 55, Essen 45147, Germany.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in neurological disorders [Ther Adv Neurol Disord] 2023 Oct 31; Vol. 16, pp. 17562864231207508. Date of Electronic Publication: 2023 Oct 31 (Print Publication: 2023).
DOI:	10.1177/17562864231207508
Abstrakt:	Background: Despite the high incidence of acute ischemic stroke (AIS) in cancer patients, there is still no consensus about the safety of recanalization therapies in this cohort. Objectives: In this observational study, our aim was to investigate the bleeding risk after acute recanalization therapy in AIS patients with active malignancy. Methods and Study Design: We retrospectively analyzed observational data of 1016 AIS patients who received intravenous thrombolysis with rtPA (IVT) and/or endovascular therapy (EVT) between January 2017 and December 2020 with a focus on patients with active malignancy. The primary safety endpoint was the occurrence of stroke treatment-related major bleeding events, that is, symptomatic intracranial hemorrhage (SICH) and/or relevant systemic bleeding. The primary efficacy endpoint was neurological improvement during hospital stay (NI). Results: None of the 79 AIS patients with active malignancy suffered from stroke treatment-related systemic bleeding. The increased rate (7.6% versus 4.7%) of SICH after therapy compared to the control group was explained by confounding factors. A total of nine patients with cerebral tumor manifestation received acute stroke therapy, two of them suffered from stroke treatment-related intracranial hemorrhage remote from the tumor, both asymptomatic. The group of patients with active malignancy and the control group showed comparable rates of NI. Conclusion: Recanalization therapy in AIS patients with active malignancy was not associated with a higher risk for stroke treatment-related systemic or intracranial bleeding. IVT and/or EVT can be regarded as a safe therapy option for AIS patients with active malignancy. Competing Interests: The authors declare that there is no conflict of interest. (© The Author(s), 2023.)
Databáze:	MEDLINE
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