Resuscitated patient after simultaneous intravascular thrombolytic therapy for massive pulmonary embolism and embolization of an injured hepatic artery : a case report

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We report a case of successful management of a massive pulmonary embolism (PE) with simultaneous hepatic arterial injury using anticoagulation and interventional radiology (IVR). The patient, with pre-existing muscle atrophy, decreased lower extremity mobility, and spinal stenosis, developed bilateral PE during rehabilitation. Following cardiopulmonary arrest, chest compressions for resuscitation resulted in hepatic hemorrhage. The patient was treated with intravenous heparin, transcatheter arterial embolization, thrombectomy, and blood transfusion, leading to full recovery without neurological complications. This case highlights the importance of assessing PE risk in hospitalized patients and highlights the efficacy of IVR in complex cases. J. Med. Invest. 72 : 177-181, February, 2025