Safety and Efficacy of Reperfusion Therapies for Acute Ischemic Stroke Patients With Active Malignancy

Fabrizio Sallustio, Alfredo Paolo Mascolo, Federico Marrama, Giacomo Koch, Fana Alemseged, Alessandro Davoli, Valerio Da Ros, Daniele Morosetti, Daniel Konda, Marina Diomedi

Research output: Contribution to journalArticle

Abstract

Background and Purpose: Epidemiological correlations between active malignancy (AM) and acute ischemic stroke (AIS) are well-established. However, the effect of reperfusion strategies, particularly mechanical thrombectomy (MT), has been barely investigated in patients with AIS and AM. We aim to evaluate safety and efficacy of reperfusion strategies in such patients. Materials and Methods: We performed a case-control analysis comparing patients with AM and AIS (AM group) to a group of cancer-free patients with AIS (control group). All enrolled patients underwent reperfusion therapies (i.e. intravenous thrombolysis, MT, intravenous thrombolysis plus MT). Main outcomes were 3-month functional independence, successful reperfusion, 3-month mortality, symptomatic intracranial hemorrhage. Results: Total 24 patients with AM and AIS (mean age: 69 ± 10.1) were individually matched to 24 control patients (mean age: 70.7 ± 9.3). In both groups 50% were treated with MT, 46% with intravenous thrombolysis and 4% with intravenous thrombolysis plus MT. No difference were found in successful reperfusion, 3-month functional independence, symptomatic intracranial hemorrhage, and mortality. However an overall mortality of 33% in the AM group was reported. Conclusions: Reperfusion strategies for AIS patients with AM seem to be safe and effective. However an individualized approach to understand cancer stage and life-expectation is warranted.

Original languageEnglish
JournalJournal of Stroke and Cerebrovascular Diseases
DOIs
Publication statusPublished - Jan 1 2019

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Reperfusion
Stroke
Thrombectomy
Safety
Mechanical Thrombolysis
Neoplasms
Therapeutics
Intracranial Hemorrhages
Mortality
Control Groups

Keywords

  • active malignancy
  • Acute ischemic stroke
  • efficacy
  • reperfusion strategies
  • safety

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Safety and Efficacy of Reperfusion Therapies for Acute Ischemic Stroke Patients With Active Malignancy. / Sallustio, Fabrizio; Mascolo, Alfredo Paolo; Marrama, Federico; Koch, Giacomo; Alemseged, Fana; Davoli, Alessandro; Da Ros, Valerio; Morosetti, Daniele; Konda, Daniel; Diomedi, Marina.

In: Journal of Stroke and Cerebrovascular Diseases, 01.01.2019.

Research output: Contribution to journalArticle

Sallustio, Fabrizio ; Mascolo, Alfredo Paolo ; Marrama, Federico ; Koch, Giacomo ; Alemseged, Fana ; Davoli, Alessandro ; Da Ros, Valerio ; Morosetti, Daniele ; Konda, Daniel ; Diomedi, Marina. / Safety and Efficacy of Reperfusion Therapies for Acute Ischemic Stroke Patients With Active Malignancy. In: Journal of Stroke and Cerebrovascular Diseases. 2019.
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AU - Mascolo, Alfredo Paolo

AU - Marrama, Federico

AU - Koch, Giacomo

AU - Alemseged, Fana

AU - Davoli, Alessandro

AU - Da Ros, Valerio

AU - Morosetti, Daniele

AU - Konda, Daniel

AU - Diomedi, Marina

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