Absence of Susceptibility Vessel Sign in Patients With Malignancy-Related Acute Ischemic Stroke Treated With Mechanical Thrombectomy.

Beyeler, Morin; Belachew, Nebiyat F; Kielkopf, Moritz; Aleman, Enrique B; Léon Betancourt, Alejandro Xavier; Genceviciute, Kotryna; Kurmann, Christoph; Grunder, Lorenz; Birner, Barbara; Meinel, Thomas R; Scutelnic, Adrian; Bücke, Philipp; Seiffge, David J; Dobrocky, Tomas; Piechowiak, Eike I; Pilgram-Pastor, Sara; Mattle, Heinrich P; Mordasini, Pasquale; Arnold, Marcel; Fischer, Urs; ... (2022). Absence of Susceptibility Vessel Sign in Patients With Malignancy-Related Acute Ischemic Stroke Treated With Mechanical Thrombectomy. Frontiers in neurology, 13, p. 930635. Frontiers Media S.A. 10.3389/fneur.2022.930635

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Background and Purpose

Clots rich in platelets and fibrin retrieved from patients with acute ischemic stroke (AIS) have been shown to be independently associated with the absence of the susceptibility vessel sign (SVS) on MRI and active malignancy. This study analyzed the association of SVS and the presence of active malignancy in patients with AIS who underwent mechanical thrombectomy (MT).


This single-center, retrospective, and cross-sectional study included consecutive patients with AIS with admission MRI treated with MT between January 2010 and December 2018. SVS status was evaluated on susceptibility-weighted imaging. Adjusted odds ratios (aORs) were calculated to determine the association between absent SVS and the presence of active or occult malignancy. The performance of predictive models incorporating and excluding SVS status was compared using areas under the receiver operating characteristics curve (auROC).


Of 577 patients with AIS with assessable SVS status, 40 (6.9%) had a documented active malignancy and 72 (12.5%) showed no SVS. The absence of SVS was associated with active malignancy (aOR 4.85, 95% CI 1.94-12.11) or occult malignancy (aOR 11.42, 95% CI 2.36-55.20). The auROC of predictive models, including demographics and common malignancy biomarkers, was higher but not significant (0.85 vs. 0.81, p = 0.07) when SVS status was included.


Absence of SVS on admission MRI of patients with AIS undergoing MT is associated with malignancy, regardless of whether known or occult. Therefore, the SVS might be helpful in detecting paraneoplastic coagulation disorders and occult malignancy in patients with AIS.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Beyeler, Morin, Belachew, Nebiyat Filate, Kielkopf, Moritz Christopher, Léon Betancourt, Alejandro Xavier, Kurmann, Christoph Carmelino, Grunder, Lorenz Nicolas, Birner, Barbara, Meinel, Thomas Raphael, Scutelnic, Adrian, Bücke, Philipp Jonas, Seiffge, David Julian, Dobrocky, Tomas, Piechowiak, Eike Immo, Pilgram-Pastor, Sara Magdalena, Mattle, Heinrich, Mordasini, Pasquale Ranato, Arnold, Marcel, Fischer, Urs Martin, Pabst, Thomas Niklaus, Gralla, Jan, Berger, Martin Dave, Jung, Simon, Kaesmacher, Johannes


600 Technology > 610 Medicine & health




Frontiers Media S.A.




Pubmed Import

Date Deposited:

03 Aug 2022 12:13

Last Modified:

02 Mar 2023 23:36

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

biomarkers ischemic stroke malignancy-related stroke mechanical thrombectomy paraneoplastic coagulation disorders susceptibility vessel sign thrombus composition/occult malignancy





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