Publications

Authors:

Cappellari, Manuel; Carletti, Monica; Micheletti, Nicola; Tomelleri, Giampaolo; Ajena, Domenico; Moretto, Giuseppe; Bovi, P.

Title:

Intravenous Alteplase for acute ischemic stroke in patients with current malignant neoplasm.

Year:

2013

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Format:

A Stampa

Referee:

Sì

Name of journal:

Journal of the Neurological Sciences

ISSN of journal:

0022-510X

N° Volume:

325

Number or Folder:

1-2

Page numbers:

100-102

Keyword:

intravenous thrombolysis; Acute ischemic stroke; Cancer

Short description of contents:

BACKGROUND: The current European license for Alteplase in acute ischemic stroke excludes the patients who have neoplasm with increased bleeding, but this criterion is not clearly defined. The aim of the present study is to assess whether intravenous (IV) thrombolysis is safe and effective in patients with current non-malignant neoplasm in absence of metastatic disease or other additional risk factors of bleeding. METHODS: We reviewed the clinical characteristics of 11 thrombolysed patients with current malignant neoplasm. We decided to treat only patients who did not have one or more of the following additional risk factors of bleeding: metastatic malignant disease; recent bleeding; documented hemorrhagic diathesis, also including baseline normal platelet count, activated partial thromboplastin time and prothrombin time value; and anticoagulant treatment on admission. RESULTS: Cancer was diagnosed before IV thrombolysis in 9 patients, while non-metastatic malignant disease was incidentally detected after IV thrombolysis in 2 patients. None of the patients showed severe hemorrhagic complications. At 7days, all patients that showed a reduction of 4 points or more in the National Institutes of Health Stroke Scale from baseline were asymptomatic. At 3months, functional outcome was favorable in 7 (73%) patients. CONCLUSIONS: Our experience suggests that IV thrombolysis does not appear to increase the risk of hemorrhagic complications in current non-metastatic cancer patients in absence of additional risk factors of bleeding. In addition, these patients showed clinical improvement after IV thrombolysis, although replication of our findings in a randomized controlled trial is required to confirm our results.

Product ID:

76425

Handle IRIS:

11562/520550

Deposited On:

December 11, 2013

Last Modified:

November 14, 2022

Bibliographic citation:

Cappellari, Manuel; Carletti, Monica; Micheletti, Nicola; Tomelleri, Giampaolo; Ajena, Domenico; Moretto, Giuseppe; Bovi, P., Intravenous Alteplase for acute ischemic stroke in patients with current malignant neoplasm. «Journal of the Neurological Sciences» , vol. 325 , n. 1-2 , 2013 , pp. 100-102

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