Endovascular thrombectomy in selected patients with active cancer and thrombocytopenia: outcomes under an institutional platelet transfusion practice - Scorecard - MDSpire
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Endovascular thrombectomy in selected patients with active cancer and thrombocytopenia: outcomes under an institutional platelet transfusion practice
Clinical Scorecard: Outcomes of Endovascular Thrombectomy in Patients with Active Cancer and Thrombocytopenia: Insights from an Institutional Platelet Transfusion Protocol
At a Glance
Category
Detail
Condition
Active Cancer with Thrombocytopenia
Key Mechanisms
Thrombocytopenia can result from chemotherapy, bone marrow infiltration, or disseminated intravascular coagulation, raising concerns about hemorrhagic complications during EVT.
Target Population
Patients with active cancer undergoing EVT for anterior-circulation large vessel occlusion.
Care Setting
Multicenter study involving three tertiary centers.
Key Highlights
Thrombocytopenia was not significantly associated with increased rates of hemorrhagic complications during EVT.
Patients with thrombocytopenia had worse functional outcomes at 90 days compared to those without.
The study utilized propensity score matching to balance baseline characteristics.
Guideline-Based Recommendations
Diagnosis
Active cancer diagnosed within 6 months, recurrent or metastatic cancer, or current treatment with chemotherapy or radiotherapy.
Management
Patients with moderate-to-severe thrombocytopenia (<100 × 10^9/L) received platelet transfusions prior to EVT.
Monitoring & Follow-up
Monitor for symptomatic intracranial hemorrhage and hemorrhagic transformation post-EVT.
Risks
Increased mortality and worse functional status observed in thrombocytopenic patients post-EVT.
Patient & Prescribing Data
Adult patients aged ≥18 years with active cancer and anterior-circulation LVO.
EVT is increasingly considered for patients with active cancer despite thrombocytopenia.
Clinical Best Practices
Utilize platelet transfusion protocols for patients with moderate-to-severe thrombocytopenia undergoing EVT.
Consider the overall prognosis and functional status when evaluating EVT candidacy in patients with active cancer.
