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Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer
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Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer
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Journal Article
Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer
2019
Overview
Background and purposeThis study aimed to evaluate the efficacy of intra-arterial thrombectomy (IAT) and prognosis for acute ischaemic stroke patients with active cancer.MethodsWe 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).ResultsInitial 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).ConclusionsAlthough 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.
Publisher
Springer Nature B.V
Subject
