BackgroundCancer-related cerebral embolism due to direct tumor embolization results in a rare acute ischemic stroke with large vessel occlusion (LVO). Despite the established status of mechanical thrombectomy (MT) in LVO management, its effectiveness and safety remains inadequately explored in this specific patient group.MethodsWe conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the Nested Knowledge AutoLit software, encompassing databases like Embase, PubMed, Scopus, and Web of Science, from their inception up to 9 May 2023.ResultsIn the review of 35 studies encompassing 37 cases, mean patient age was 52 years, and 30% were female. Cardiac myxoma (29.7%), cardiac papillary fibroelastoma (16.2%), and squamous cell carcinoma of the lung (8.1%) were the most frequent underlying cancers. The left middle cerebral artery was the most commonly affected occlusion site (24.3%). Of the patients, 67.5% underwent MT alone, while 32.5% received MT combined with intravenous thrombolysis. Successful reperfusion (thrombolysis in cerebral infarction (TICI) 2b–3) was achieved in 89.1% of cases, with 59.4% reaching TICI 3. Functional independence was observed in 29.7% of patients.ConclusionWhile limitations exist, this comprehensive study highlights the potential benefits of MT in a patient group historically excluded from major trials, warranting further investigation.

中文翻译：

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机械取栓治疗癌症相关脑栓塞引起的大血管闭塞：系统评价

背景直接肿瘤栓塞导致的癌症相关脑栓塞导致罕见的急性缺血性中风伴大血管闭塞（LVO）。尽管机械取栓 (MT) 在 LVO 管理中的地位已确立，但其有效性和安全性在这一特定患者群体中仍未得到充分探索。方法我们使用嵌套知识 AutoLit，按照系统评价和荟萃分析指南的首选报告项目进行了系统评价软件，涵盖 Embase、PubMed、Scopus 和 Web of Science 等数据库，从成立到 2023 年 5 月 9 日。结果在对涵盖 37 个病例的 35 项研究的回顾中，患者平均年龄为 52 岁，其中 30% 为女性。心脏粘液瘤（29.7%）、心脏乳头状弹力纤维瘤（16.2%）和肺鳞状细胞癌（8.1%）是最常见的潜在癌症。左侧大脑中动脉是最常受影响的闭塞部位（24.3%）。其中67.5%的患者仅接受MT治疗，32.5%的患者接受MT联合静脉溶栓治疗。89.1% 的病例成功再灌注（脑梗塞溶栓 (TICI) 2b-3），其中 59.4% 达到 TICI 3。29.7% 的患者观察到功能独立。结论虽然存在局限性，但这项综合研究强调了潜在的益处历史上，MT 在患者组中的比例被排除在主要试验之外，值得进一步研究。