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. 2025 May 19;7(1):34.
doi: 10.1186/s42466-025-00392-1.

Endovascular treatment in ischemic stroke with active cancer: retrospective analysis of university stroke center data

Athina-Maria Aloizou  1 , David-Dimitrios Chlorogiannis  2 , Daniel Richter  3 , Theodoros Mavridis  4   5 , Dimitra Aloizou  6 , Carsten Lukas  7   8 , Ralf Gold  9   8 , Christos Krogias  3   8
Affiliations

Endovascular treatment in ischemic stroke with active cancer: retrospective analysis of university stroke center data

Athina-Maria Aloizou et al. Neurol Res Pract. .

Abstract

Introduction: Active cancer (AC) associates strongly with ischemic stroke (IS). Intravenous thrombolysis (IVT) is often contraindicated in AC, and endovascular treatment (EVT) is considered the gold treatment standard, although data on its safety and efficacy is scarce.

Methods: Digital records of patients receiving EVT in a tertiary university hospital with comprehensive stroke center from 2016 to 2022 were assessed. Demographic, clinical, and laboratory parameters were extracted and compared between patients with and without AC. In-hospital mortality was set as the primary outcome.

Results: 39 AC and 297 non-AC patients were included. No significant differences were reported in demographic and baseline stroke parameters (NIHSS, mRS, stroke etiology). In-hospital mortality did not differ between groups (11/39 vs. 57/297, p > 0.99). Successful recanalization, change in mRS and NIHSS from admission to discharge, periinterventional complications, and stroke-related mortality were also comparable. Significantly fewer AC patients received IVT. In the binary logistic regression analysis (adjusting for confounder variables), older age, large artery atherosclerosis, unsuccessful recanalization, and higher admission NIHSS were independent predictors of all-cause in-hospital mortality (aOR): 1.04, 95% confidence interval (CI): 1.01-1.08; OR: 3.21, 95% CI: 1.03-9.92, OR: 7.28, 95% CI: 3.61-15.1, OR: 1.07, 95% CI: 1.01-1.14, p-value < 0.05, respectively).

Conclusions: EVT was shown as safe and effective in AC patients as in non-AC patients. Long-term functional outcomes are often poorer in AC, due to the cancer itself, but given how oncological treatment depends on functional status, AC patients should be considered for EVT.

Keywords: Cancer; Coagulopathy; Endovascular treatment; Ischemic stroke; Mortality; Thrombectomy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The ethics committee of Ruhr-University Bochum approved this study (RUB Register Number 108 022 25352 7). Consent was not necessary. Competing interests: The authors declare that they have no competing interests in this section.

Figures

Fig. 1
Fig. 1
STROBE flowchart for patient inclusion selection
Fig. 2
Fig. 2
mRS Shift diagram for patients with and without active cancer
See this image and copyright information in PMC

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