Acute ischemic stroke due to large vessel occlusion associated with active malignancy
Conditions
Interventions
None listed
Sponsors
University of Tsukuba
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: (1) Adults aged 18 years or older. (2) Patients who were hospitalized and treated at participating institutions between January 1, 2018, and December 31, 2024. (3) Patients with acute ischemic stroke who were admitted within 24 hours from symptom onset or from last known well time, who also had active malignancy (including in-hospital stroke onset and patients diagnosed with active malignancy after stroke onset). (4) Patients who developed ischemic stroke due to acute large vessel occlusion (common carotid artery [CCA], internal carotid artery [ICA], M1 or M2 segment of the middle cerebral artery [MCA], vertebral artery [VA], or basilar artery [BA]). (5) Patients with a National Institutes of Health Stroke Scale (NIHSS) score of 6 or higher at onset. (6) Patients with an Alberta Stroke Program Early CT Score (ASPECTS) of 3 or higher for anterior circulation occlusions, or a posterior circulation Acute Stroke Prognosis Early CT Score (pc-ASPECTS) of 6 or higher for posterior circulation occlusions, assessed by non-contrast CT or diffusion-weighted MRI (DWI).
Exclusion criteria
Exclusion criteria: (1) The patient or the legal representative expresses a refusal to participate. (2) The attending physician determines that the patient is ineligible for enrollment in the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary Efficacy Endpoint: A composite outcome of either discharge to home within 90 days after stroke onset, or a mRS score of 0-2 or a return to the pre-stroke mRS score at 90 days after onset. Primary Safety Endpoints: All-cause mortality within 90 days after stroke onset, symptomatic intracranial hemorrhage (sICH) within 7 days after onset. | — |
Secondary
| Measure | Time frame |
|---|---|
| Discharge to home within 90 days after onset. At discharge and at 90 days after onset: mRS score, mRS 0-2, return to the pre-stroke mRS score, composite outcome of achieving mRS 0-2 or returning to the pre-stroke mRS score. Initiation or resumption of active cancer treatment (surgical resection, chemotherapy, radiotherapy, or other therapies aimed at cure or life-prolongation) within 90 days after stroke onset. Asymptomatic intracranial hemorrhage (ICH) or any ICH (classified according to the Heidelberg Bleeding Classification) within 7 days after onset. Rate of successful reperfusion (defined as modified Thrombolysis in Cerebral Infarction [mTICI] grade 2b, 2c, or 3) and rate of complete reperfusion in the EVT group. Subgroup analyses stratified by clinically relevant factors such as stroke subtype, cancer stage and others. | — |
Countries
Japan
Contacts
Public ContactMIKITO HAYAKAWA
University of Tsukuba Hospital Department of Stroke and Cerebrovascular Diseases
Outcome results
None listed