2025 American Academy of Neurology Abstract Website

Objective:

To review the literature on tumor embolic stroke (TES) undergoing endovascular thrombectomy (EVT).

Background:

Although it is well recognized, the literature regarding EVT in TES is scarce. Some studies have found a high risk of intracranial hemorrhage (ICH) after thrombolysis in patients with cancer-related stroke (CRS).

Design/Methods:

The PubMed (Medline) database was used to find the studies in electronic form about EVT in TES published to June 2024. The search terms to use for the search were “tumor, stroke, and thrombectomy.” There was no language restriction. The initial search obtained 177 studies, from which 50 were selected. Only fragment or entire tumor dislodgement resulting in a stroke, which is a subset of CRS, was included.

Results:

The median age was 45.8, female subjects comprised 15 out of 50, gender was not reported in 2 and the rest were male. 7/50 were pediatric cases with age <21. 1 case reported adverse outcomes, the rest did not have complications from EVT. Deaths reported later in the hospital course were primarily attributable to complications from underlying malignancy or respiratory failure. 24/50 TES were secondary to myxoma. Several other tumors, including but not limited to cardiac papillary fibroelastomas, amorphous tumors, sarcomas, and renal cell carcinomas, resulted in TES. The rate of ICH in TES is comparable to that of patients without active malignancy (5–10% in both groups).

Conclusions:

A literature review suggests EVT is safe in TES, and novel techniques improve outcomes. The rate of ICH in patients undergoing EVT for stroke is similar in patients with and without cancer. EVT demonstrates safety in TES. Several novel techniques of EVT demonstrate safety and efficacy in treating TES; in certain cases, outcomes are superior to medical management alone.