Thrombolysis for Ischemic Stroke in Patients with Brain Tumors

Etgen, Thorleif; Steinich, Ines; Gsottschneider, L.

doi:10.1016/j.jstrokecerebrovasdis.2013.05.004

Cited by 40 publications

(33 citation statements)

References 21 publications

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“…Hsieh and Chen 274 similarly reported the safe administration of intravenous alteplase in the setting of a meningioma. Etgen et al 275 performed a literature review of intravenous alteplase administration in the setting of brain tumors that included a 12th meningioma case; this review uncovered only a single sICH that occurred in a patient with GBM. Thus, no case of sICH referable to extra-axial neoplasms exists in the literature.…”

Section: Intracranial Neoplasmsmentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

569

237

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Purpose-To critically review and evaluate the science behind individual eligibility criteria (indication/inclusion and contraindications/exclusion criteria) for intravenous recombinant tissue-type plasminogen activator (alteplase) treatment in acute ischemic stroke. This will allow us to better inform stroke providers of quantitative and qualitative risks associated with alteplase administration under selected commonly and uncommonly encountered clinical circumstances and to identify future research priorities concerning these eligibility criteria, which could potentially expand the safe and judicious use of alteplase and improve outcomes after stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association Stroke Council's Scientific Statement Oversight Committee and the American Heart Association's Manuscript Oversight Committee. The writers used systematic literature reviews, references to published clinical and epidemiology studies, morbidity and mortality reports, clinical and public health guidelines, authoritative statements, personal files, and expert opinion to summarize existing evidence and to indicate gaps in current knowledge and, when appropriate, formulated recommendations using standard American Heart Association criteria. All members of the writing group had the opportunity to comment on and approved the final version of this document. The document underwent extensive American Heart Association internal peer review, Stroke The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on September 24, 2015, and the American Heart Association Executive Committee on October 5, 2015. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@ wolterskluwer.com.The online-only Data Supplement, which contains literature search strategies and Figures A, B, and C, is available with this article at http://circ. ahajournals.org/lookup/suppl/doi:10.1161/STR.0000000000000086/-/DC1.The American Heart Association requests that this document be cited as follows: Demaerschalk BM, Kleindorfer DO, Adeoye OM, Demchuk AM, Fugate JE, Grotta JC, Khalessi AA, Levy EI, Palesch YY, Prabhakaran S, Saposnik G, Saver JL, Smith EE; on behalf of the American Heart Association Stroke Council and Council on Epidemiology and Prevention. Scientific rational...

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Section: Intracranial Neoplasmsmentioning

confidence: 99%

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Demaerschalk¹,

Kleindorfer²,

Adeoye³

et al. 2016

Stroke

569

237

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“…In fact, systemic thrombolysis has been administered for non-neurologic indications such as pulmonary embolism and acute myocardial infarction in the setting of known brain tumors including glioblastoma, without any untoward events [15][16][17]. In a review of 12 patients with BTS treated with intravenous thrombolysis, ICH occurred in only one patient who had a glioblastoma, while there were no complications in the other patients with benign brain tumors [9]. There are also anecdotal reports of successful intra-arterial thrombolysis for AIS in the setting of benign brain tumors [18].…”

Section: Discussionmentioning

confidence: 99%

“…Recent retrospective observational studies have suggested that thrombolysis outcomes may be favorable in patients with systemic malignancies, with no difference in ICH rates among liquid, solid or metastatic tumors [7,8]. On the other hand, literature on outcome of stroke thrombolysis in patients with brain tumors is limited to case reports with possible publication bias for favorable outcomes [9]. Therefore, we aimed to compare the outcomes of thrombolysis in patients with BTS with non-brain tumor-associated strokes (NBTS) in a population-based cross-sectional study using a large national health database.…”

Section: Introductionmentioning

confidence: 99%

In-hospital outcomes of thrombolysis for acute ischemic stroke in patients with primary brain tumors

Murthy

Moradiya

Shah

et al. 2015

Journal of Clinical Neuroscience

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“…There are few reports of intravenous thrombolysis in patients with primary or metastatic brain tumors. 68,69 Although these case series report mostly low hemorrhage rates, publication bias is likely, and common sense dictates avoiding thrombolysis in patients with malignant brain tumors, as stroke mimics and risk of hemorrhage are likely high. However, intravenous thrombolysis may be carefully considered in stroke patients with benign brain tumors, particularly if small and extra-axial.…”

Section: Acute Recanalization Therapiesmentioning

confidence: 99%

Ischemic stroke in cancer patients: A review of an underappreciated pathology

Navi

Iadecola

2018

Annals of Neurology

192

188

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Currently 1 in 10 patients with ischemic stroke have comorbid cancer, and this frequency is expected to increase with continued advances in cancer therapeutics prolonging median survival. Well known for its association with venous thrombosis, cancer has recently emerged as a significant risk factor for arterial thromboembolism, including stroke; however, the underlying mechanisms are uncertain. In addition, the optimal strategies to prevent and acutely treat stroke in cancer patients are yet to be established. This review summarizes the current evidence on ischemic stroke risk, biomarkers, pathophysiology, treatments, and prognosis in cancer patients, emphasizing knowledge gaps and the potential strategies to address them. Ann Neurol 2018;83:873-883.

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Thrombolysis for Ischemic Stroke in Patients with Brain Tumors

Cited by 40 publications

References 21 publications

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke

In-hospital outcomes of thrombolysis for acute ischemic stroke in patients with primary brain tumors

Ischemic stroke in cancer patients: A review of an underappreciated pathology

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