Acute ischemic stroke and concomitant massive pulmonary embolism: a challenge

AbstractSilent pulmonary embolism (PE) may be associated with acute ischemic stroke (AIS). We identified 10 patients from 3,132 unique patients (3,431 CT scans). We retrospectively examined CT angiogram of patients with AIS to determine the frequency of concurrent PE in AIS. The period prevalence of PE was 0.32. Seven patients had concurrent PE, whereas three had PE diagnosed 2 days after their AIS presentation. We suspected paradoxical embolism via patent foramen ovale as the cause of stroke in three patients and thrombophilia in four patients. Seven patients had poor outcome including four deaths. CT angiogram stroke protocol images from aortic arch to vertex allows visualization of upper pulmonary arteries and PE detection in AIS.

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Pulmonary Embolism in Acute Ischemic Stroke: Effect on Short-Term Outcomes (P01.037)

Neurology ◽

10.1212/wnl.78.1_meetingabstracts.p01.037 ◽

2012 ◽

Vol 78 (Meeting Abstracts 1) ◽

pp. P01.037-P01.037

Author(s):

Y. Moradiya ◽

K. Patel ◽

D. Miller

Keyword(s):

Pulmonary Embolism ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Short Term

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Experience With Serelaksin for Acute Right Ventricular Failure due to Pulmonary Embolism in Acute Ischemic Stroke

Kardiologiia ◽

10.18565/cardio.2016.2.68-72 ◽

2016 ◽

Vol 2_2016 ◽

pp. 68-72

Author(s):

L.A. Shpagina Shpagina ◽

T.N. Surovenko Surovenko ◽

L.A. Panacheva Panacheva ◽

E.M. Loktin Loktin ◽

V.N. Kohno Kohno ◽

...

Keyword(s):

Pulmonary Embolism ◽

Ischemic Stroke ◽

Right Ventricular ◽

Acute Ischemic Stroke ◽

Right Ventricular Failure ◽

Ventricular Failure ◽

Acute Right Ventricular Failure

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Management dilemmas in acute ischemic stroke and concomitant acute pulmonary embolism: Case series and literature review

eNeurologicalSci ◽

10.1016/j.ensci.2021.100341 ◽

2021 ◽

pp. 100341

Author(s):

Faddi G. Saleh Velez ◽

Jorge G. Ortiz Garcia

Keyword(s):

Pulmonary Embolism ◽

Ischemic Stroke ◽

Literature Review ◽

Acute Ischemic Stroke ◽

Acute Pulmonary Embolism ◽

Case Series

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Multiple Recurrent Acute Ischemic Strokes Treated by Thrombectomy in a Patient with Acute Pulmonary Embolism

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2019.187 ◽

2019 ◽

Vol 7 (5) ◽

pp. 801-804

Author(s):

Ton Mai Duy ◽

Luu Vu Dang ◽

Phuong Dao Viet ◽

Chi Nguyen Van ◽

Quang Anh Nguyen ◽

...

Keyword(s):

Pulmonary Embolism ◽

Ischemic Stroke ◽

Case Report ◽

Acute Ischemic Stroke ◽

Treatment Plan ◽

Cerebral Arteries ◽

Pulmonary Arteries ◽

Vessel Occlusion ◽

Brain Vessels ◽

The Brain

BACKGROUND: Thrombectomy is recommended to treat for an acute ischemic stroke (AIS) patient with anterior large vessel occlusion. However, there were neither detailed guidelines nor systematic reviews of acute ischemic stroke patients having multiple times or re-occluded arteries. CASE REPORT: In our case report, we struggled a multiple (4-times) AIS patient underwent by one intravenous r-tpA and 3 remaining of endovascular treatment of thrombectomy. Especially, the finding of both pulmonary embolism and cerebral arteries occlusion in this patient made us difficult to decide the appropriate treatment plan. The patient was considered having multiple cardiac thrombi pumping out to the brain and pulmonary vessels even in treatment with NOAC (New Oral Anticoagulant). Our priority, normally, was to recanalize the brain vessels compared to the pulmonary arteries. CONCLUSION: In conclusion, based on this noticed case study, we want to share our experiences on the diagnosis of ischemic stroke, the strategy in treatment and prevention with anticoagulant therapy.

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