Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction

Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with an...

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Veröffentlicht in:Neurologia Medico-Chirurgica 2024, pp.2024-0016
Hauptverfasser: TERAZONO, Sayaka, SAKAEYAMA, Yuki, FUCHINOUE, Yutaka, MIKAI, Masataka, KUBOTA, Shuhei, ABE, Mitsuyoshi, KONDO, Kosuke, SUGO, Nobuo, NAGAO, Takaaki, NEMOTO, Masaaki
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container_end_page 433
container_issue 12
container_start_page 2024-0016
container_title Neurologia Medico-Chirurgica
container_volume 64
creator TERAZONO, Sayaka
SAKAEYAMA, Yuki
FUCHINOUE, Yutaka
MIKAI, Masataka
KUBOTA, Shuhei
ABE, Mitsuyoshi
KONDO, Kosuke
SUGO, Nobuo
NAGAO, Takaaki
NEMOTO, Masaaki
description Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). Aggressive treatment may be recommended to patients with cancer and/or a history of cancer who present with a systemic condition that can be managed with MT.
doi_str_mv 10.2176/jns-nmc.2024-0016
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However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). 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Med. Chir.(Tokyo)</addtitle><description>Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). 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Med. Chir.(Tokyo)</addtitle><date>2024-12-15</date><risdate>2024</risdate><volume>64</volume><issue>12</issue><spage>2024-0016</spage><epage>433</epage><pages>2024-0016-433</pages><artnum>2024-0016</artnum><issn>0470-8105</issn><eissn>1349-8029</eissn><abstract>Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). Aggressive treatment may be recommended to patients with cancer and/or a history of cancer who present with a systemic condition that can be managed with MT.</abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>39505523</pmid><doi>10.2176/jns-nmc.2024-0016</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aged, 80 and over
Bats
Cancer
carcinoma
Cerebral blood flow
Cerebral infarction
Cerebral Infarction - etiology
Cerebral Infarction - therapy
Female
Humans
Ischemia
Male
mechanical thrombectomy
Middle Aged
Multivariate analysis
Neoplasms - complications
Original
Patients
Retrospective Studies
Stroke
t-Plasminogen activator
Thrombectomy - methods
Thrombolysis
Tissue Plasminogen Activator - administration & dosage
Tissue Plasminogen Activator - therapeutic use
Treatment Outcome
Trousseau syndrome
title Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction
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