Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Aloizou, Athina-Maria, Richter, Daniel, Charles James, Jeyanthan, Lukas, Carsten, Gold, Ralf, Krogias, Christos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410462/
https://www.ncbi.nlm.nih.gov/pubmed/36012933
http://dx.doi.org/10.3390/jcm11164696
_version_ 1784775099173306368
author Aloizou, Athina-Maria
Richter, Daniel
Charles James, Jeyanthan
Lukas, Carsten
Gold, Ralf
Krogias, Christos
author_facet Aloizou, Athina-Maria
Richter, Daniel
Charles James, Jeyanthan
Lukas, Carsten
Gold, Ralf
Krogias, Christos
author_sort Aloizou, Athina-Maria
collection PubMed
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.
format Online
Article
Text
id pubmed-9410462
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94104622022-08-26 Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review Aloizou, Athina-Maria Richter, Daniel Charles James, Jeyanthan Lukas, Carsten Gold, Ralf Krogias, Christos J Clin Med 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 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. MDPI 2022-08-11 /pmc/articles/PMC9410462/ /pubmed/36012933 http://dx.doi.org/10.3390/jcm11164696 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Aloizou, Athina-Maria
Richter, Daniel
Charles James, Jeyanthan
Lukas, Carsten
Gold, Ralf
Krogias, Christos
Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review
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 Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410462/
https://www.ncbi.nlm.nih.gov/pubmed/36012933
http://dx.doi.org/10.3390/jcm11164696
work_keys_str_mv AT aloizouathinamaria mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview
AT richterdaniel mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview
AT charlesjamesjeyanthan mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview
AT lukascarsten mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview
AT goldralf mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview
AT krogiaschristos mechanicalthrombectomyforacuteischemicstrokeinpatientswithmalignancyasystematicreview