Objective:

To compare the procedural safety and clinical outcomes of endovascular thrombectomy (EVT) between patients with active cancer with and without thrombocytopenia.

Approach:

Key Findings:

• No statistically significant differences in hemorrhagic complications between thrombocytopenic and non-thrombocytopenic groups (HT: p > 0.99; sICH: p > 0.99).
• At 90 days, the thrombocytopenia group had worse functional status (median mRS 6 [IQR 3–6] vs. 3 [IQR 1–6]; p = 0.029).
• Trends indicated fewer favorable outcomes in the thrombocytopenia group (mRS 0–2: 17.5% vs. 37.5%; p = 0.080) and higher mortality (55% vs. 37.5%; p = 0.179).
• Thrombocytopenia was not significantly associated with hemorrhagic complications in adjusted analyses.

Interpretation:

Thrombocytopenia in patients with active cancer undergoing EVT did not show a statistically demonstrable increase in hemorrhagic complications; however, findings should be interpreted cautiously due to limited event numbers and potential confounding.

Limitations:

• Limited event numbers.
• Residual confounding.
• Absence of an untreated thrombocytopenic comparator group.

Conclusion:

Thrombocytopenia was not associated with increased hemorrhagic complications in this exploratory study.

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