Panicucci Emilie, Bruno Chiara, Ferrari Victoria, Suissa Laurent
Intensive Care Stroke Unit, Pasteur2 Hospital, University Hospital of Nice, Voie romaine, 06000 Nice, France.
Oncology Unit, University Hospital of Nice, Nice, France.
J Cardiol Cases. 2020 Nov 24;23(5):242-245. doi: 10.1016/j.jccase.2020.11.010. eCollection 2021 May.
Venous thromboembolism (VTE) and arterial thromboembolism (ATE) are frequent complications in cancer patients. For curative treatment of VTE in a neoplastic context, recent randomized controlled trials and meta-analyses suggest that direct oral anticoagulants (DOACs) can be an alternative to conventional treatment by low molecular weight heparins (LMWHs). On the other hand, the role of DOACs in the treatment of cancer-related ATE remains unclear. Here, we report a case of stroke recurrence in a patient initially treated with DOACs that were started for cancer-related VTE. The failure of the DOACs, compared to LMWHs, to prevent the stroke recurrence led us to the infrequent final diagnosis of nonbacterial thrombotic (formerly known as < Arterial (ATE) and venous thromboembolism (VTE) are frequent complications in cancer patients. ATE and VTE can be responsible for ischemic stroke in neoplastic context. VTE-associated stroke in cancer patients does not exclude ATE etiology (marantic endocarditis). Direct oral anticoagulants fail to prevent ischemic stroke associated with marantic endocarditis.>.
静脉血栓栓塞（VTE）和动脉血栓栓塞（ATE）是癌症患者常见的并发症。对于肿瘤患者VTE的根治性治疗，最近的随机对照试验和荟萃分析表明，直接口服抗凝剂（DOACs）可作为低分子量肝素（LMWHs）常规治疗的替代方案。另一方面，DOACs在癌症相关ATE治疗中的作用仍不明确。在此，我们报告一例最初因癌症相关VTE而开始使用DOACs治疗的患者发生中风复发的病例。与LMWHs相比，DOACs未能预防中风复发，这使我们最终罕见地诊断为非细菌性血栓形成（以前称为<动脉（ATE）和静脉血栓栓塞（VTE）是癌症患者常见的并发症。ATE和VTE可导致肿瘤患者发生缺血性中风。癌症患者中VTE相关中风不排除ATE病因（消耗性心内膜炎）。直接口服抗凝剂无法预防与消耗性心内膜炎相关的缺血性中风。> ） 。
