Usefulness of Mechanical Thrombectomy in Patients with Cancer Who Developed Cerebral Infarction.

IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY
Sayaka Terazono, Yuki Sakaeyama, Yutaka Fuchinoue, Masataka Mikai, Shuhei Kubota, Mitsuyoshi Abe, Kosuke Kondo, Nobuo Sugo, Takaaki Nagao, Masaaki Nemoto
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Abstract

Mechanical thrombectomy (MT) is an established treatment for large vessel occlusion in the acute phase of stroke. However, its efficacy and safety in patients with cancer remain unclear. This study aimed to evaluate the therapeutic effect of MT against large vessel occlusion between patients with and without cancer. A total of 71 patients who underwent MT from August 2014 to November 2021 were included in this study. Patients with cancer and/or a history of cancer (n = 16) were included in the with cancer group and the remaining patients in the without cancer group (n = 55). The frequency of preoperative tissue plasminogen activator administration was significantly lower in the with cancer group (n = 2 [12.5%]) than in the without cancer group (n = 24 [43.6%]). However, there were no significant differences between the two groups in terms of treatment time, pass frequency, thrombolysis in cerebral infarction grade, modified Rankin scale score at 1 week after treatment [mRS (1w) ], modified Rankin scale score at discharge [mRS (ENT) ], modified Rankin scale score at 90 days after treatment [mRS (90 days) ], and length of hospital stay (days). In the multivariate analysis, if the objective variables were mRS (1w) and mRS (90 days), the National Institutes of Health Stroke Scale (NIHSS) and preonset mRS scores were considered significant variables. The presence or absence of cancer was not considered an independent factor of mRS (1w), mRS (ENT), or mRS (90 days). Aggressive treatment may be recommended to patients with cancer and/or a history of cancer who present with a systemic condition that can be managed with MT.

机械血栓切除术在发生脑梗塞的癌症患者中的实用性
机械血栓切除术(MT)是治疗中风急性期大血管闭塞的一种成熟疗法。然而,其对癌症患者的疗效和安全性仍不明确。本研究旨在评估机械取栓术对癌症患者和非癌症患者大血管闭塞的治疗效果。本研究共纳入了 71 名在 2014 年 8 月至 2021 年 11 月期间接受 MT 治疗的患者。癌症和/或癌症病史患者(16 人)被纳入癌症组,其余患者被纳入非癌症组(55 人)。癌症患者组(n = 2 [12.5%])术前使用组织纤溶酶原激活剂的频率明显低于非癌症患者组(n = 24 [43.6%])。不过,两组患者在治疗时间、通液频率、脑梗塞溶栓分级、治疗后 1 周的改良 Rankin 评分[mRS(1w)]、出院时的改良 Rankin 评分[mRS(ENT)]、治疗后 90 天的改良 Rankin 评分[mRS(90 天)]和住院时间(天数)方面没有明显差异。在多变量分析中,如果客观变量是 mRS(1w)和 mRS(90 天),则美国国立卫生研究院卒中量表(NIHSS)和发病前的 mRS 评分被视为重要变量。有无癌症不被认为是影响 mRS(1w)、mRS(耳鼻喉科)或 mRS(90 天)的独立因素。如果癌症患者和/或有癌症病史的患者伴有可通过 MT 治疗的全身性疾病,则建议对其进行积极治疗。
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来源期刊
Neurologia medico-chirurgica
Neurologia medico-chirurgica 医学-临床神经学
CiteScore
3.70
自引率
10.50%
发文量
63
审稿时长
3-8 weeks
期刊介绍: Information not localized
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