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Cancer is a common complication
in patients with acute ischemic stroke (AIS).
Multiple retrospective studies have shown that 5-10% of patients with AIS will have known malignancy, with the highest
risk in the first 6 months after cancer diagnosis or during aggressive chemotherapy.
For intravenous thrombolysis, national guidelines recommend that altenplase may be reasonable
in patients with a life expectancy of more than 6 months.
However, many cancer patients are not eligible for thrombolysis because of the increased incidence of contraindications, such as the simultaneous use of anticoagulation, recent major surgery, brain metastases, or blood system problems such as coagulopathy or thrombocytopenia
.
Endovascular thrombectomy (EVT) may be the only possible acute treatment for these patients, but guidelines or clinical studies to guide practice are limited
.
A study published in Neurology used a large inpatient database, the National Inpatient Sample (NIS), to examine clinical outcomes
in cancer patients undergoing EVT.
During the period 2016-2019, NIS was questioned about admissions to AIS and identified cancer patients
.
To compare baseline demographics, comorbidities, reperfusion therapy, and outcomes
in people with and without cancer with AIS.
For patients receiving EVT, preference-score matching was used to investigate primary outcomes such as risk of intracranial haemorrhage, length of hospital stay, and discharge management
.
The study shows that in modern medical practice, patients with acute stroke complicated with cancer or metastatic cancer have similar rates of intracranial hemorrhage and favorable discharge after endovascular thrombectomy compared with non-cancer patients
.
This suggests that patients with AIS who meet the criteria for recanalization may be considered for a combined cancer diagnosis
.
Sources: Shapiro SD, Vazquez S, Das A, et al.
Investigating Outcomes Post Endovascular Thrombectomy in Acute Stroke Patients With Cancer [published online ahead of print, 2022 Sep 19].
Neurology.
2022; 10.
1212/WNL.
0000000000201208.
doi:10.
1212/WNL.
0000000000201208
