ArticleNeurological research and practice2025
Endovascular treatment in ischemic stroke with active cancer: retrospective analysis of university stroke center data.
Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionActive cancer (AC) associates strongly with ischemic stroke (IS). Intravenous thrombolysis (IVT) is often contraindicated in AC, and endovascular treatment (EVT) is considered the gold treatment standard, although data on its safety and efficacy is scarce.
methodsDigital records of patients receiving EVT in a tertiary university hospital with comprehensive stroke center from 2016 to 2022 were assessed. Demographic, clinical, and laboratory parameters were extracted and compared between patients with and without AC. In-hospital mortality was set as the primary outcome.
results39 AC and 297 non-AC patients were included. No significant differences were reported in demographic and baseline stroke parameters (NIHSS, mRS, stroke etiology). In-hospital mortality did not differ between groups (11/39 vs. 57/297, p > 0.99). Successful recanalization, change in mRS and NIHSS from admission to discharge, periinterventional complications, and stroke-related mortality were also comparable. Significantly fewer AC patients received IVT. In the binary logistic regression analysis (adjusting for confounder variables), older age, large artery atherosclerosis, unsuccessful recanalization, and higher admission NIHSS were independent predictors of all-cause in-hospital mortality (aOR): 1.04, 95% confidence interval (CI): 1.01-1.08; OR: 3.21, 95% CI: 1.03-9.92, OR: 7.28, 95% CI: 3.61-15.1, OR: 1.07, 95% CI: 1.01-1.14, p-value < 0.05, respectively).
conclusionsEVT was shown as safe and effective in AC patients as in non-AC patients. Long-term functional outcomes are often poorer in AC, due to the cancer itself, but given how oncological treatment depends on functional status, AC patients should be considered for EVT.
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