Efficacy of mechanical thrombectomy in patients with ischemic stroke and cancer

Ciolli, Ludovico; Bigliardi, Guido; Ferraro, Diana; Maffei, Stefania; Vandelli, Laura; Dell’Acqua, Maria Luisa; Rosafio, Francesca; Picchetto, Livio; Laterza, Domenico; Vincenzi, Chiara; Meletti, Stefano; Vallone, Stefano; Zini, Andrea

doi:10.1016/j.jocn.2021.06.029

Cited by 17 publications

(41 citation statements)

References 8 publications

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“…All of the included studies were retrospective analyses of either files/databases of patients that received acute treatment for AIS [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ], or analyses of hospital records with the use of diagnostic codes, e.g., ICD codes for AIS and malignancy [ 20 , 21 , 22 ]. One study was a retrospective analysis of cancer patients from the MR CLEAN thrombectomy study registry [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…There was a certain amount of discrepancy regarding the patients included in the studies. Most studies included patients with AIS and an active malignancy (AM), defined as patients with a diagnosis of current or metastatic cancer, those undergoing treatment for cancer, or who refused the treatment [ 6 , 7 , 10 , 11 , 13 , 14 , 15 , 16 , 18 , 24 ], and at times patients with a diagnosis made during or after the AIS-hospitalization [ 10 , 14 , 15 ]. This definition was occasionally restricted to a diagnosis within a year or 6months, or cancer treatment within 1–6 months of the ischemic event [ 7 , 11 , 18 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…Most studies included patients with AIS and an active malignancy (AM), defined as patients with a diagnosis of current or metastatic cancer, those undergoing treatment for cancer, or who refused the treatment [ 6 , 7 , 10 , 11 , 13 , 14 , 15 , 16 , 18 , 24 ], and at times patients with a diagnosis made during or after the AIS-hospitalization [ 10 , 14 , 15 ]. This definition was occasionally restricted to a diagnosis within a year or 6months, or cancer treatment within 1–6 months of the ischemic event [ 7 , 11 , 18 , 23 ]. Others utilized ICD codes pertaining to active and metastatic malignancies [ 20 , 21 , 22 ], while certain studies analyzed all patients with any history of cancer [ 9 ], or did not provide a solid definition of active/underlying cancer [ 17 ].…”

Section: Resultsmentioning

confidence: 99%

“…Regarding baseline characteristics ( Table 2 ), patients allocated in the malignancy groups were often found to be younger [ 13 , 18 ] and with lower rates of common stroke risk factors, such as atrial fibrillation, hyperlipidemia, and diabetes [ 7 , 10 , 11 , 12 , 13 , 14 , 16 , 18 , 20 , 21 , 23 , 25 ]. No study reported higher comorbidity rates in CPs; only one reported higher smoking rates in CPs [ 23 ], though smoking is also considered a major malignancy risk factor.…”

Section: Resultsmentioning

confidence: 99%

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Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review

Aloizou

Richter

James

et al. 2022

JCM

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review

Aloizou

Richter

James

et al. 2022

JCM

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“…Furthermore, the radiotherapy and chemotherapy drugs and surgery used in tumor treatment also significantly impact the body ( Sooklal and Siddiki, 2021 ). Some retrospective studies have reported a risk of CIS in patients with malignant tumors, such as prostate cancer, head and neck tumors, colorectal cancer, and cervical cancer, and most of these patients have no traditional CIS risk factors ( Aspberg et al, 2020 ; Ciolli et al, 2021 ), suggesting that the occurrence of CIS in some patients with malignant tumors is unrelated to the pathogenesis of traditional cerebrovascular diseases but is directly or indirectly related to tumors, which is called tumor-related CIS. Lung cancer (LC) is one of the tumors with the highest incidence worldwide, and its death rate is increasing.…”

Section: Introductionmentioning

confidence: 99%

Upregulation of CCNB2 and Its Perspective Mechanisms in Cerebral Ischemic Stroke and All Subtypes of Lung Cancer: A Comprehensive Study

Yan

Chen

et al. 2022

Front. Integr. Neurosci.

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Cyclin B2 (CCNB2) belongs to type B cell cycle family protein, which is located on chromosome 15q22, and it binds to cyclin-dependent kinases (CDKs) to regulate their activities. In this study, 103 high-throughput datasets related to all subtypes of lung cancer (LC) and cerebral ischemic stroke (CIS) with the data of CCNB2 expression were collected. The analysis of standard mean deviation (SMD) and summary receiver operating characteristic (SROC) reflecting expression status demonstrated significant up-regulation of CCNB2 in LC and CIS (Lung adenocarcinoma: SMD = 1.40, 95%CI [0.98–1.83], SROC = 0.92, 95%CI [0.89–0.94]. Lung squamous cell carcinoma: SMD = 2.56, 95%CI [1.64–3.48]. SROC = 0.97, 95%CI [0.95–0.98]. Lung small cell carcinoma: SMD = 3.01, 95%CI [2.01–4.01]. SROC = 0.98, 95%CI [0.97–0.99]. CIS: SMD = 0.29, 95%CI [0.05–0.53], SROC = 0.68, 95%CI [0.63–0.71]). Simultaneously, protein-protein interaction (PPI) analysis indicated that CCNB2 is the hub molecule of crossed high-expressed genes in CIS and LC. Through Multiscale embedded gene co-expression network analysis (MEGENA), a gene module of CIS including 76 genes was obtained and function enrichment analysis of the CCNB2 module genes implied that CCNB2 may participate in the processes in the formation of CIS and tissue damage caused by CIS, such as “cell cycle,” “protein kinase activity,” and “glycosphingolipid biosynthesis.” Afterward, via single-cell RNA-seq analysis, CCNB2 was found up-regulated on GABAergic neurons in brain organoids as well as T cells expressing proliferative molecules in LUAD. Concurrently, the expression of CCNB2 distributed similarly to TOP2A as a module marker of cell proliferation in cell cluster. These findings can help in the field of the pathogenesis of LC-related CIS and neuron repair after CIS damage.

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Cancer‐related stroke: Exploring personalized therapy strategies

et al. 2022

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Background: Cancer and ischemic stroke are two common diseases that threaten human health and have become the main causes of death in the world. It is estimated that one-in-ten patients with ischemic stroke have concomitant cancer, and this incidence is expected to increase as improvements in medical technology extends the life expectancy of cancer patients.Discussion: Cancer-related stroke (CRS) refers to unexplained ischemic stroke in patients with active cancer that cannot be explained by current stroke mechanisms.Available evidence suggests that CRS accounts for 5-10% of embolic stroke of undetermined source (ESUS). Although the incidence of CRS is gradually increasing, its underlying pathogenesis remains unclear. Also, there is no consensus on acute treatment and secondary prevention of stroke. Conclusion:In this review, we retrospectively analyzed the incidence, mechanisms of CRS, its potential as a new stroke subtype, options for acute treatment, secondary prevention strategies, and disease progression, with the aim of attempting to explore personalized therapy strategies.

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Efficacy of mechanical thrombectomy in patients with ischemic stroke and cancer

Cited by 17 publications

References 8 publications

Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review

Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Malignancy: A Systematic Review

Upregulation of CCNB2 and Its Perspective Mechanisms in Cerebral Ischemic Stroke and All Subtypes of Lung Cancer: A Comprehensive Study

Cancer‐related stroke: Exploring personalized therapy strategies

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