Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review
Background: Ischemic stroke is a common occurrence in patients with concomitant malignancy. Systemic thrombolysis is often contraindicated in these patients, and mechanical thrombectomy (MT) is the preferred method of intervention. This review aims to collect the available data on the safety and eff...
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| Format: | Article |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4696 |
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| author | Athina-Maria Aloizou Daniel Richter Jeyanthan Charles James Carsten Lukas Ralf Gold Christos Krogias |
| author_facet | Athina-Maria Aloizou Daniel Richter Jeyanthan Charles James Carsten Lukas Ralf Gold Christos Krogias |
| author_sort | Athina-Maria Aloizou |
| collection | DOAJ |
| description | Background: Ischemic stroke is a common occurrence in patients with concomitant malignancy. Systemic thrombolysis is often contraindicated in these patients, and mechanical thrombectomy (MT) is the preferred method of intervention. This review aims to collect the available data on the safety and efficacy of MT in cancer patients (CPs).Methods: The PubMed/MEDLINE and SCOPUS databases were systematically searched for studies assessing safety (mortality, intracranial hemorrhage) and efficacy (reperfusion, functional outcome) indices in CPs receiving MT. Potentially relevant parameters examined in solitary studies were also extracted (e.g., stroke recurrence, brain malignancy).Results: A total of 18 retrospective studies of various methodologies and objectives were identified. Rates of in-hospital mortality, intracranial hemorrhage of any kind, reperfusion rates, and discharge condition did not seem to present any considerable differences between CPs and patients without cancer. On the contrary, 90-day mortality was higher and 90-day functional independence was lower in CPs. Three studies on cancer-related stroke (no other identifiable etiology and high D-dimer levels in the presence of active cancer) showed constant tendencies towards unfavorable conditions. Conclusions: Per the available evidence, MT appears to be a safe treatment option for CPs. It is still unclear whether the 90-day mortality and outcome rates are more heavily influenced by the malignancy and not the intervention itself, so MT can be considered in CPs with prospects of a good functional recovery, undertaking an individualized approach. |
| first_indexed | 2024-03-09T13:12:27Z |
| format | Article |
| id | doaj.art-48369d41df7242f6bc5e6884de4fe474 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T13:12:27Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-48369d41df7242f6bc5e6884de4fe4742023-11-30T21:40:32ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116469610.3390/jcm11164696Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic ReviewAthina-Maria Aloizou0Daniel Richter1Jeyanthan Charles James2Carsten Lukas3Ralf Gold4Christos Krogias5Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44892 Bochum, GermanyDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44892 Bochum, GermanyDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44892 Bochum, GermanyInstitute of Neuroradiology, St. Josef-Hospital Bochum, Ruhr University Bochum, 44892 Bochum, GermanyDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44892 Bochum, GermanyDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, 44892 Bochum, GermanyBackground: Ischemic stroke is a common occurrence in patients with concomitant malignancy. Systemic thrombolysis is often contraindicated in these patients, and mechanical thrombectomy (MT) is the preferred method of intervention. This review aims to collect the available data on the safety and efficacy of MT in cancer patients (CPs).Methods: The PubMed/MEDLINE and SCOPUS databases were systematically searched for studies assessing safety (mortality, intracranial hemorrhage) and efficacy (reperfusion, functional outcome) indices in CPs receiving MT. Potentially relevant parameters examined in solitary studies were also extracted (e.g., stroke recurrence, brain malignancy).Results: A total of 18 retrospective studies of various methodologies and objectives were identified. Rates of in-hospital mortality, intracranial hemorrhage of any kind, reperfusion rates, and discharge condition did not seem to present any considerable differences between CPs and patients without cancer. On the contrary, 90-day mortality was higher and 90-day functional independence was lower in CPs. Three studies on cancer-related stroke (no other identifiable etiology and high D-dimer levels in the presence of active cancer) showed constant tendencies towards unfavorable conditions. Conclusions: Per the available evidence, MT appears to be a safe treatment option for CPs. It is still unclear whether the 90-day mortality and outcome rates are more heavily influenced by the malignancy and not the intervention itself, so MT can be considered in CPs with prospects of a good functional recovery, undertaking an individualized approach.https://www.mdpi.com/2077-0383/11/16/4696ischemic strokecancer-related strokethrombectomymalignancy |
| spellingShingle | Athina-Maria Aloizou Daniel Richter Jeyanthan Charles James Carsten Lukas Ralf Gold Christos Krogias Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review Journal of Clinical Medicine ischemic stroke cancer-related stroke thrombectomy malignancy |
| title | Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review |
| title_full | Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review |
| title_fullStr | Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review |
| title_full_unstemmed | Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review |
| title_short | Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review |
| title_sort | mechanical thrombectomy for acute ischemic stroke in patients with malignancy a systematic review |
| topic | ischemic stroke cancer-related stroke thrombectomy malignancy |
| url | https://www.mdpi.com/2077-0383/11/16/4696 |
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