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Introduction: Nonbacterial thrombotic endocarditis (NBTE) involves sterile vegetations on heart valves due to systemic hypercoagulability, often linked to malignancies. It is frequently underdiagnosed and presents significant clinical management challenges, often manifesting as thromboembolic events like ischemic stroke. We aim to report the first case of cancerassociated NBTE that showed a positive response to rivaroxaban as a maintenance anticoagulant, with 3D echocardiographic evidence of vegetation reduction, and to evaluate the performance of direct oral anticoagulants (DOACs) in treating cancer-associated NBTE through a systematic review of case reports.
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As endovascular therapy for ischemic stroke has advanced, we are getting increasing opportunities to study cerebral thromboemboli histologically. These opportunities have not been fully exploited, but some reports suggest that thromboemboli retrieved from cancer patients with stroke are platelet-richer than those from non-cancer patients. Nonbacterial thrombotic endocarditis (NBTE) is an important cause of ischemic stroke in cancer patients.
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