尽管癌症患者急性缺血性卒中（AIS）的发病率很高，但对该队列中再通治疗的安全性仍没有达成共识。在这项观察性研究中，我们的目的是调查AIS患者急性再通治疗后的出血风险我们回顾性分析了 2017 年 1 月至 2020 年 12 月期间接受 rtPA 静脉溶栓 (IVT) 和/或血管内治疗 (EVT) 的 1016 名 AIS 患者的观察数据，重点关注患有活动性恶性肿瘤的患者。主要安全性终点是中风治疗相关的主要出血事件的发生，即症状性颅内出血（SICH）和/或相关的全身出血。主要疗效终点是住院期间 (NI) 的神经功能改善。79 名患有活动性恶性肿瘤的 AIS 患者中没有一人出现中风治疗相关的全身出血。与对照组相比，治疗后 SICH 发生率增加（7.6% 对比 4.7%）可以用混杂因素来解释。共有9名出现脑肿瘤表现的患者接受了急性中风治疗，其中2名患者出现远离肿瘤的中风治疗相关颅内出血，且均无症状。患有活动性恶性肿瘤的患者组和对照组的 NI 发生率相当。患有活动性恶性肿瘤的 AIS 患者的再通治疗与卒中治疗相关的全身或颅内出血的较高风险无关。 IVT 和/或 EVT 可被视为患有活动性恶性肿瘤的 AIS 患者的安全治疗选择。© 作者，2023。

Despite the high incidence of acute ischemic stroke (AIS) in cancer patients, there is still no consensus about the safety of recanalization therapies in this cohort.In this observational study, our aim was to investigate the bleeding risk after acute recanalization therapy in AIS patients with active malignancy.We retrospectively analyzed observational data of 1016 AIS patients who received intravenous thrombolysis with rtPA (IVT) and/or endovascular therapy (EVT) between January 2017 and December 2020 with a focus on patients with active malignancy. The primary safety endpoint was the occurrence of stroke treatment-related major bleeding events, that is, symptomatic intracranial hemorrhage (SICH) and/or relevant systemic bleeding. The primary efficacy endpoint was neurological improvement during hospital stay (NI).None of the 79 AIS patients with active malignancy suffered from stroke treatment-related systemic bleeding. The increased rate (7.6% versus 4.7%) of SICH after therapy compared to the control group was explained by confounding factors. A total of nine patients with cerebral tumor manifestation received acute stroke therapy, two of them suffered from stroke treatment-related intracranial hemorrhage remote from the tumor, both asymptomatic. The group of patients with active malignancy and the control group showed comparable rates of NI.Recanalization therapy in AIS patients with active malignancy was not associated with a higher risk for stroke treatment-related systemic or intracranial bleeding. IVT and/or EVT can be regarded as a safe therapy option for AIS patients with active malignancy.© The Author(s), 2023.