Key result
Mechanical thrombectomy achieves successful reperfusion in ~89% of cancer-related large vessel occlusions.
Why the study?
Despite the established status of mechanical thrombectomy in large vessel occlusion management, its effectiveness and safety remained inadequately explored in patients with cancer-related cerebral embolism.
Does mechanical thrombectomy improve reperfusion and functional outcomes in patients with large vessel occlusion due to cancer-related cerebral embolism?
Systematic Review (n=37)
Does mechanical thrombectomy improve reperfusion and functional outcomes in patients with large vessel occlusion due to cancer-related cerebral embolism?
Mechanical thrombectomy achieves high rates of successful reperfusion (89.1%) in patients with large vessel occlusion due to cancer-related cerebral embolism, though functional independence is achieved in only about 30%.
May support MT consideration for reperfusion in cancer-related LVO; extends limited observational data but leaves functional outcomes open.
BACKGROUND: Cancer-related cerebral embolism due to direct tumor embolization results in a rare acute ischemic stroke with large vessel occlusion (LVO). Despite the established status of mechanical thrombectomy (MT) in LVO management, its effectiveness and safety remains inadequately explored in this specific patient group. METHODS: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the Nested Knowledge AutoLit software, encompassing databases like Embase, PubMed, Scopus, and Web of Science, from their inception up to 9 May 2023. RESULTS: In the review of 35 studies encompassing 37 cases, mean patient age was 52 years, and 30% were female. Cardiac myxoma (29.7%), cardiac papillary fibroelastoma (16.2%), and squamous cell carcinoma of the lung (8.1%) were the most frequent underlying cancers. The left middle cerebral artery was the most commonly affected occlusion site (24.3%). Of the patients, 67.5% underwent MT alone, while 32.5% received MT combined with intravenous thrombolysis. Successful reperfusion (thrombolysis in cerebral infarction (TICI) 2b-3) was achieved in 89.1% of cases, with 59.4% reaching TICI 3. Functional independence was observed in 29.7% of patients. CONCLUSION: While limitations exist, this comprehensive study highlights the potential benefits of MT in a patient group historically excluded from major trials, warranting further investigation.
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Toruno et al. (2024) conducted a systematic review in large vessel occlusion due to cancer-related cerebral embolism (n=37). Mechanical thrombectomy was evaluated on Successful reperfusion (TICI 2b-3). Mechanical thrombectomy achieved successful reperfusion (TICI 2b-3) in 89.1% of cases of large vessel occlusion due to cancer-related cerebral embolism.
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