Retrospective cohort study identifies predictors of death despite recanalization in cancer patients, suggesting implications for EVT decisions.
Key Points
This study aims to identify predictors of mortality despite successful recanalization in cancer patients undergoing endovascular thrombectomy for large vessel occlusion.
Analyzed 153 patients with active cancer and EVT-eligible large vessel occlusion from 2017-2024 across four tertiary stroke centers.
Performed 1:1 propensity score matching to compare EVT and non-EVT management outcomes.
Assessed primary outcomes including death within 3 months despite successful recanalization and secondary outcomes of early post-stroke death and functional outcomes.
In the matched cohort, EVT did not show significant reduction in mortality, with a 43% death rate despite successful recanalization.
Systemic metastasis and elevated D-dimer levels were strong predictors of early mortality.
Achieving a first-pass effect was independently associated with favorable functional outcomes among 3-month EVT survivors.