Antithrombotic Therapy Strategy for Cancer-Associated Ischemic Stroke: A Case Series of 26 Patients

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Hiroyuki NaitoHirofumi Maruyama

Abstract

The risk of complications from thromboembolism is increased for patients with malignancy. Cancer-associated stroke is also a serious issue with regard to the management of patients with cancer because stroke incidence often causes disabilities that affect daily life and cancer treatment strategy. Between March 2011 and September 2017, 328 patients with acute ischemic stroke were registered to our hospital. Of these patients, 26 (7.9%) had a cancer-associated stroke diagnosis, namely, Trousseau syndrome. After ischemic stroke onset, malignancy treatment was changed to palliative treatment for 11 patients. Eighteen patients died 1 year after ischemic stroke onset, and 15 of these patients underwent cancer treatment according to the best supportive care policy. Of those who died, 8 underwent anticoagulation therapy. We described the clinical courses of 3 cases among 26 cases with Trousseau syndrome. Two cases took direct oral anticoagulants (DOACs) due to cancer-associated venous thromboembolism before stroke onset, and there has been no stroke recurrence with subcutaneous unfractionated heparin. In the third case, when cancer activity was suppressed, we changed DOACs from subcutaneous unfractionated heparin and continued DOACs wi...Continue Reading

Citations

Aug 24, 2019·Current Neurology and Neuroscience Reports·Harold P Adams
Jun 21, 2019·International Cancer Conference Journal·Takuya OyakawaMasatoshi Kusuhara

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