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Original research
Mechanical thrombectomy in patients with acute cancer-related stroke: is the stent retriever alone effective?
  1. Yejin Jeon1,
  2. Sung Hyun Baik1,
  3. Cheolkyu Jung1,
  4. Jun Yup Kim2,
  5. Beom Joon Kim2,
  6. Jihoon Kang2,
  7. Hee-Joon Bae2,
  8. Jae Hyoung Kim1
  1. 1 Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
  2. 2 Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea
  1. Correspondence to Dr Sung Hyun Baik, Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea; mdshbaik{at}gmail.com

Abstract

Background The optimal first-line mechanical thrombectomy (MT) method in cancer-related stroke (CRS) patients with emergent large vessel occlusion (ELVO) remains largely unknown. The aim of this study is to evaluate the efficacy and safety between contact aspiration (CA) first-line thrombectomy and stent retriever (SR) first-line thrombectomy in CRS patients.

Methods Sixty-two CRS patients with ELVO, who underwent MT between January 2013 and October 2019 at our institution, were retrospectively analyzed. Patients were divided into two groups based on the first-line MT method and compared: the CA group (n=28), which included those who received CA alone or combined CA with SR, and the SR group (n=34), which included those who received conventional SR alone.

Results Overall, reperfusion was successful in 75.8% (47/62) of CRS patients, and a good clinical outcome at 90 days was observed in 17.7%. The CA group showed a higher rate of successful reperfusion (89.3% vs 64.7%, P=0.025) shorter procedure time (22 vs 42 min; P=0.029), higher rate of first pass effect (35.7% vs 11.8%, P=0.025), and lower number of passes (1 vs 3, P=0.023) when compared with the SR group. The procedural and hemorrhagic complication rates were similar between the CA and SR groups. The first-line contact aspiration (OR 11.624, 95% CI 1.041 to 129.752; P=0.046) was an independent predictor of successful reperfusion.

Conclusions Among patients with CRS, CA – whether alone or in combination with SR – as first-line MT seems to provide more rapid and successful reperfusion when compared with SR.

  • stroke
  • thrombectomy
  • malignant

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Footnotes

  • Contributors Substantial contribution to the conception or design of the work: SHB. Acquisition, analysis, or interpretation of the data for the work: YJ, CJ, JYK, BJK, JK, H-JB, JHK, and SHB. Drafting the work or revising it critically for important intellectual content: YJ, CJ, and SHB. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: YJ, CJ, JYK, and SHB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

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