Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072

この記事には本公開記事があります。本公開記事を参照してください。
引用する場合も本公開記事を引用してください。

Paradoxical Cerebral Embolization Caused by Thrombus-In-Transit via a Patent Foramen Ovale in a Patient with Symptomatic Pulmonary Embolism: A Case Report
Hiroki SuenagaJunya TsurukiriTakahisa KatoKyosuke MatsunagaNaoko OgawaAkito OiwaNaruaki OtakeJushi Numata
著者情報
ジャーナル オープンアクセス 早期公開

論文ID: cr.2021-0003

この記事には本公開記事があります。
詳細
抄録

Objective: Acute pulmonary embolism (PE) is a life-threatening cardiovascular event associated with high mortality and morbidity. The presence of a patent foramen ovale (PFO) in patients with acute PE represents a risk factor for mortality. Furthermore, a thrombus-in-transit via a PFO with impending paradoxical embolism carries a high mortality rate.

Case Presentation: An adult patient with ischemic stroke caused by paradoxical embolism following PE underwent mechanical thrombectomy and achieved successful recanalization. Initial CT pulmonary angiography (CTPA) showed not only pulmonary thromboemboli but also bilateral atrial thromboemboli. During hospitalization, transesophageal echocardiography (TEE) revealed the PFO with a right-to-left shunt. Two months after rehabilitation undergone by the patient, PE completely disappeared and PFO closure was conducted to reduce the recurrence risk of ischemic stroke.

Conclusion: Not only cardiologists but also interventional neurologists should understand that CTPA can demonstrate the thrombus-in-transit through the PFO and provides a reliable prediction of the sudden onset of ischemic stroke in patients with symptomatic PE. When identified, considering a case-by-case treatment approach by multidisciplinary teams is essential for preventing further life-threatening paradoxical embolization.

著者関連情報
© 2021 The Japanese Society for Neuroendovascular Therapy

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
feedback
Top