We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Intra-arterial thrombectomy for acute ischaemic stroke patients with active cancer.
- Authors
Lee, Dongwhane; Lee, Deok Hee; Suh, Dae Chul; Kwon, Hyuk Sung; Jeong, Da-Eun; Kim, Joong-Goo; Lee, Ji-Sung; Kim, Jong S.; Kang, Dong-Wha; Jeon, Sang-Beom; Lee, Eun-Jae; Noh, Kyung Chul; Kwon, Sun U.
- 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.
- Subjects
NATIONAL Institutes of Health (U.S.); STROKE; STROKE patients; CANCER patients
- Publication
Journal of Neurology, 2019, Vol 266, Issue 9, p2286
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-019-09416-8