The Simultaneous Occurrence of Deep Vein Thrombosis and Pulmonary and Arterial Embolization

Dixon, Teabra; Panda, Mukta; Desbiens, Norman A.

doi:10.1007/s11606-007-0169-5

Cited by 9 publications

(6 citation statements)

References 5 publications

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“…While ultimately this patient expired, possibly due to a delay in presentation to the emergency department, this case demonstrates the importance of rapid diagnosis of this time-sensitive condition and the ease and feasibility of point-of-care ultrasound in diagnosing peripheral arterial occlusion. Additionally, to the authors' best knowledge, while rarely noted on CTA or MRA, no previous reports of a concurrent discovery of both arterial and venous thrombosis in the same limb have been noted on point-of-care ultrasound to date [16][17][18].…”

Section: Discussionmentioning

confidence: 77%

Diagnosis of abdominal mural aortic thrombus following discovery of common femoral artery and vein thrombosis by point-of-care ultrasound

et al. 2015

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Acute limb ischemia (ALI) is a limb-threatening and life-threatening disease process. Mural aortic thrombosis (MAT) is a rare cause of ALI. While there is limited evidence on the use of bedside ultrasound for the detection of ALI or MAT, duplex ultrasound remains the standard in the diagnosis and ultimate medical decision-making in patients with acute and chronic limb ischemia. Point-of-care ultrasound may be used in the evaluation of patients with signs and symptoms of this disease entity. This is a case of a 79-year-old female with a complicated medical history, who presented with a pulseless right leg and abdominal tenderness. The patient quickly decompensated requiring intubation for airway protection. A post-intubation arterial blood gas (ABG) was unsuccessfully attempted in the right femoral artery, prompting an ultrasound-guided ABG. On B-mode ultrasound evaluation, echogenic material was visualized in the right common femoral artery without evidence of Doppler flow signal. Additionally, a partially obstructing echogenic material was also noted at the femorosaphenous vein junction with only partial compressibility by compression sonography. A computed tomography angiography of the aorta was performed indicating extensive infrarenal aortic thrombosis. The patient expired despite the relatively prompt diagnosis, highlighting the importance of early identification of acute arterial occlusion.Keywords Mural aortic thrombus Á Acute limb ischemia Á Point-of-care ultrasound Á Bedside ultrasound Á Arterial thrombus Á Deep vein thrombosis Riassunto L'ischemia acuta degli arti inferiori (ALI) è una malattia che mette in pericolo gli arti e la vita stessa del paziente. La trombosi parietale dell'aorta (MAT) è una causa rara di ALI. Mentre vi è una limitata evidenza sull'uso dell'ecografia al letto del paziente per la rilevazione di ALI o MAT, il Doppler rimane lo standard nella diagnosi e nel processo decisionale medico finale, in pazienti con ischemia acuta e cronica degli arti. L'ecografia può essere utilizzata nella valutazione dei pazienti con segni e sintomi di questa malattia. Presentiamo il caso di una donna di 79 anni, con una complicata storia clinica che si è presentata senza polso nella gamba destra e tensione addominale. La paziente si scompensava rapidamente, richiedendo l'intubazione per la protezione delle vie respiratorie. Dopo l'intubazione è stato tentato un arterial blood gas test (ABG) nell'arteria femorale destra, senza successo spingendo verso un ABG con guida ecografica. La valutazione ecografica in B-mode ha evidenziato materiale ecogeno nell'arteria femorale comune destra senza evidenza di segnali Doppler. Inoltre materiale ecogeno ostruente è stato osservato a livello della giunzione femoro-safena con solo parziale compressibilità con la compressione ecografica. E' stata effettuata un'angio tomografia computerizzata dell'aorta che ha evidenziato un'ampia trombosi dell'aorta sotto-renale. Il paziente moriva, nonostante la diagnosi in tempi relativamente brevi, mettendo in evidenza l...

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Section: Discussionmentioning

confidence: 77%

Diagnosis of abdominal mural aortic thrombus following discovery of common femoral artery and vein thrombosis by point-of-care ultrasound

et al. 2015

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“…2 Despite this relatively high prevalence, there are paradoxical emboli and cases of combined pulmonary and paradoxical embolism, described in literature as rare. [3][4][5][6][7][8] Paradoxical emboli represent about 2% of arterial embolizations. 3 Depending on the site of embolization, paradoxical embolism can cause a wide range of symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…One of the other mechanisms of increased pressure in the pulmonary artery is successive embolization that subsequently increases vascular resistance. 7 It can be therefore suggested, that in a case of positive neurological presentation with an unclear source of embolism, it may be appropriate to consider the possibility of a simultaneously occurring submassive pulmonary embolism. By that, we can avoid the later consequences such as chronic thromboembolic pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of simultaneous pulmonary and paradoxical embolism

Ilčišák¹,

Ničovský²,

Němec³

2022

Cor Vasa

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Je prezentován případ pacienta s atypickými symptomy vzhledem k jeho primární diagnóze. Pacient měl primárně neurologickou symptomatiku. Při vyšetření výpočetní tomografi í (CT) byla prokázána kombinovaná plicní i systémová embolie. Následná předoperační jícnová echokardiografi e (TEE) prokázala perzistentní foramen ovale (PFO), které bylo patrně cestou k systémové embolizaci, jež vyvolala neurologickou symptomatiku. V kazuistice uvádíme způsob chirurgické léčby kombinované plicní a systémové embolie.

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“…Certainly faculty, given their broader perspective and experience, have an important role in identifying cases that are reportable by dint of their being unusual or particularly demonstrative of teaching points. 19 However, once this has been done, the principles of adult education suggest that residents should have the major responsibility in seeking the assistance of appropriate faculty or other residents to develop the abstract and poster. 20 The faculty should not harass or badger residents to write up the case.…”

Section: Discussionmentioning

confidence: 99%