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Ischemic Stroke

Cryptogenic embolic stroke with active cancer

Cryptogenic embolic stroke without active cancer

Chin-Sang Chung, MD, PhD

Although there has been increasing interest in the association between cancer and cerebrovascular disease, the underlying pathophysiology of stroke in cancer patients is still not fully understood. The aim of this study is to investigate the stroke mechanisms in patients with cancer-associated stroke.

Patients with cryptogenic embolic stroke will be prospectively enrolled and categorized into two groups according to the presence of active cancer: cryptogenic embolic stroke with active cancer (cancer-associated stroke) vs. without active cancer (cryptogenic embolic stroke). All patients will undergo brain MRI/MRA, 12-lead electrocardiography, transthoracic and transesophageal echocardiography with injection of agitated saline, and 24-hour Holter and/or telemonitoring. Duplex ultrasonography to detect venous thrombosis of the lower extremity will also be performed in patients with a positive right-to-left shunt on echocardiography.

Identification the Cause of Cerebral Infarction in Patients With Cancer

Venous thromboembolism was investigated via Doppler sonography and/or computed tomography pulmonary angiography combined with venous phase CT angiography of the lower extremities. Microembolic signal was detected via transcranial Doppler sonography on symptomatic cerebral circulation

Infarct volume was measured by diffusion-weighted MR imaging and apparent diffusion coefficient calculated from imaging data. Univariate and multivariate linear regression was performed in ESUS patients with cancer (adjusted for age, sex, overt DIC).

Survival time (in years) was measured by subtracting admission date from the date the patient had expired. Cox proportional hazard analysis was used to evaluate association between intravascular thrombosis and survival (adjusted for age, sex, NIHSS, presence of overt DIC, infarct volume, metastasis, and histologic type).

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Identification the Cause of Cerebral Infarction in Patients With Cancer	NCT02212496	Cryptogenic Emb... Active Cancer		18 Years -	Samsung Medical Center
Identification the Cause of Cerebral Infarction in Patients With Cancer	NCT02212496	Cryptogenic Emb... Active Cancer		18 Years -	Samsung Medical Center

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