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Published in: Journal of Neurology 9/2019

01-09-2019 | Cerebral Hemorrhage | Original Communication

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

Authors: Dongwhane Lee, Deok Hee Lee, Dae Chul Suh, Hyuk Sung Kwon, Da-Eun Jeong, Joong-Goo Kim, Ji-Sung Lee, Jong S. Kim, Dong-Wha Kang, Sang-Beom Jeon, Eun-Jae Lee, Kyung Chul Noh, Sun U. Kwon

Published in: Journal of Neurology | Issue 9/2019

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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.

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).

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).

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.
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Metadata
Title
Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer
Authors
Dongwhane Lee
Deok Hee Lee
Dae Chul Suh
Hyuk Sung Kwon
Da-Eun Jeong
Joong-Goo Kim
Ji-Sung Lee
Jong S. Kim
Dong-Wha Kang
Sang-Beom Jeon
Eun-Jae Lee
Kyung Chul Noh
Sun U. Kwon
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2019
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-019-09416-8

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