{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T05:10:56Z","timestamp":1779340256256,"version":"3.51.4"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiac intimal sarcoma is a rare and aggressive malignancy, often presenting with embolic complications such as stroke. Basilar artery occlusion (BAO) is a life-threatening neurological emergency caused by several mechanisms, most commonly embolism (including cardioembolism) and intracranial atherosclerotic disease (with thrombotic occlusion).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 77-year-old man with a history of coronary heart disease, cerebral infarction, and hypertension presented with acute speech impairment and progressive consciousness disturbance. NIHSS score was 28. The electrocardiogram showed atrial fibrillation. Non-contrast head computed tomography ruled out hemorrhage. Intravenous tenecteplase (22.5\u2005mg) was administered before platelet count results were available, which later revealed thrombocytopenia (54\u2009\u00d7\u200910\u2079\/L). Emergency mechanical thrombectomy retrieved a 4-cm thrombus from the basilar apex. Histopathology and immunohistochemistry confirmed a diagnosis of intimal sarcoma. Post-procedure, the patient developed multi-organ bleeding and coagulopathy, requiring continuous renal replacement therapy. Despite successful revascularization (NIHSS improved to 10), the patient succumbed to complications of advanced malignancy and hematologic dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights that cardiac intimal sarcoma can present as acute BAO. Histopathological analysis of thrombectomy-retrieved embolic material can establish the diagnosis, obviating the need for invasive cardiac biopsy. Intravenous thrombolysis in the setting of unrecognized thrombocytopenia or malignancy-associated hemostatic dysfunction may carry substantial bleeding risk and warrants careful patient selection, urgent laboratory confirmation when feasible, and multidisciplinary management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1797980","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:43:33Z","timestamp":1779338613000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac intimal sarcoma presenting as basilar artery occlusion treated with tenecteplase and thrombectomy: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Qianqian","family":"Wang","sequence":"first","affiliation":[{"name":"Intensive Care Unit, Department of Neurology, Affiliated Hospital of Jining Medical University","place":["Jining, 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