scholarly journals Recurrent pulmonary embolism related with Paget–Schroetter syndrome: a case report

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Yuki Sahashi ◽  
Junko Naito ◽  
Masanori Kawasaki
Keyword(s):  
Pulmonary Embolism ◽  
Lifestyle Modification ◽  
Axillary Vein ◽  
Vein Thrombosis ◽  
Cardiology Department ◽  
Recurrent Pulmonary Embolism ◽  
The Right ◽  
Contrast Ct ◽  
First Rib Resection ◽  
Deep Vein

Abstract Background Paget–Schroetter syndrome (PSS) is an unusual cause of venous thromboembolism, which is frequently misdiagnosed and undiagnosed in clinical settings. Although axillary-subclavian vein thrombosis is related with PSS typically presents in healthy young athletes, it is possible for this phenomenon to occur in various age settings. Case summary We present a case of recurrent pulmonary embolism caused by a thrombus in dilated axillary vein related with PSS. A 74-year-old man was referred to our cardiology department for chest discomfort and hypoxaemia. The contrast computed tomography (CT) revealed that he suffered from bilateral pulmonary embolism. However, we could not find the source of embolism despite other examinations such as ultrasonography of the inferior limb deep vein. Three months later, the patient complained of dyspnoea for a second time, and a contrast CT scan was subsequently performed revealing a new pulmonary embolism. Surgical resection of the giant thrombus was performed, resulting in a good clinical course without recurrence. Discussion We experienced a case of recurring pulmonary embolism in a patient with undiagnosed PSS, which was related to the active and vigorous movement of the right arm during his working. Although there are various treatments for PSS including anticoagulation, first rib resection, and lifestyle modification, we need to consider what is the best treatment individually.

Saddle pulmonary embolism with fluorouracil: A case report

2020 ◽  
Vol 26 (7) ◽  
pp. 1769-1773
Author(s):  
Kylee E White ◽  
Christopher T Elder
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Single Agent ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Additive Risk ◽  
The Right ◽  
Deep Vein ◽  
To Receive

Introduction As a single agent, fluorouracil has been documented to have a small but present chance of causing extravasation of the port when not properly administered. It has also been shown that cancer patients receiving chemotherapy are at increased risk of deep vein thrombosis, symptomatic or silent. Case report A 43-year-old male patient with stage III colon cancer receiving FOLFOX developed a saddle pulmonary embolism involving possible extravasation that was discovered following cycle 3 of chemotherapy. CT scan and lower extremity Doppler confirmed non-occlusive deep vein thrombosis along with saddle pulmonary embolism. Management and outcome: For acute management, patient underwent bilateral pulmonary artery thrombolysis. Following this, the patient was initiated on rivaroxaban indefinitely. The right subclavian port was removed, and a new port was placed in the left subclavian. Patient went on to receive three more cycles of chemotherapy. Discussion Fluorouracil, an inflammitant, has been shown to have damaging potential, especially in terms of the integrity of the endothelium. Over time, this can lead to serious complications such as cardiotoxicity, including deep vein thrombosis formation. Based on how and when the thrombi were discovered, it is not possible to deduce whether the port, the 5-FU, extravasation or other factors were the precipitators of the formation of the thrombi. The combination of chemotherapy treatment along with CVC placement appears to have an additive risk to the formation of a thrombus. Practitioners should take caution when evaluating for extravasation and CVC integrity and note other potential differentials for causes, including deep vein thrombosis/saddle pulmonary embolism formation.

Venous Thrombo-Embolism in Childhood

1975 ◽  
Author(s):  
I. M. G. Macintyre ◽  
D. R. B. Jones ◽  
G. V. Ruckley
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thrombosis ◽  
Umbilical Vein ◽  
Correct Diagnosis ◽  
Renal Vein Thrombosis ◽  
Axillary Vein ◽  
Vein Thrombosis ◽  
Axillary Vein Thrombosis ◽  
Atrial Shunt ◽  
Deep Vein

Venous thrombo-embolism has been considered to be rare in infancy and childhood. Hospital in-patient statistics in Scotland over a 4-year period were examined. Forty-nine patients aged 15 years or less had been coded as venous thrombosis. After computer and clinical errors had been removed 36 cases remained. Renal vein thrombosis accounted for 12 of these, caval thrombosis following ventriculo-atrial shunt 4, cerebral thrombophlebitis 3, umbilical vein thrombosis 2, pulmonary thrombosis in infancy 2, axillary vein thrombosis 2 and jugular venous thrombosis 1. There were 10 cases of deep vein thrombosis of the lower limb and a clinical study of these is the subject of this paper. Two patients also had pulmonary embolism and two others developed chronic venous insufficiency. Children at high risk are those with sepsis or trauma. Venous thrombosis may simulate osteomyelitis and pulmonary embolism may be misdiagnosed as bronchopneumonia. Clinicians must be aware of the possibility of thrombo-embolism in childhood if correct diagnosis and treatment is to be instituted.

scholarly journals Large diverticulum of the urinary bladder: A rare cause of deep vein thrombosis with consecutive pulmonary embolism

2015 ◽  
Vol 9 (5-6) ◽  
pp. 321
Author(s):  
Oliver Zimmermann ◽  
Jan Torzewski ◽  
Ekkehard Reichenbach-Klinke ◽  
Christine Zenk
Keyword(s):  
Pulmonary Embolism ◽  
Urinary Bladder ◽  
Left Kidney ◽  
Pulmonary Arteries ◽  
Vein Thrombosis ◽  
Progressive Dyspnea ◽  
Vena Femoralis ◽  
The Right ◽  
Deep Vein ◽  
Vena Femoralis Superficialis

A 73-year-old man was admitted with progressive dyspnea; he also had benign prostatic hyperplasia (BPH). An angio computed tomography scan showed pulmonary embolism with thrombi in both main pulmonary arteries. By duplex ultrasonography, we detected a thrombus in the right vena femoralis superficialis and vena femoralis communis. Simultaneously, we also noticed a large diverticulum on the right side of the urinary bladder and urinary stasis II of the left kidney. We consider the BPH as the trigger for a secondary diverticulum of the urinary bladder. As a result of its large dimensions, mechanical compression of the deep right pelvic veins resulted in thrombosis which finally caused the pulmonary embolism. With respect to the urinary stasis II, surgical excavation of the diverticulum with infravesical desobstruction was planned. The potentially lethal course of large diverticula may require surgery.

Temporary caval filter in the prevention of pulmonary embolism during delivery and postpartum

2005 ◽  
Vol 20 (4) ◽  
pp. 183-189
Author(s):  
G Pagliariccio ◽  
L Carbonari ◽  
C Grilli Cicilioni ◽  
A Angelini ◽  
E Gatta ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Lower Limbs ◽  
X Ray ◽  
Vein Thrombosis ◽  
Caval Filter ◽  
Prophylactic Use ◽  
The Right ◽  
Deep Vein ◽  
Mean Time

Objectives: The treatment of deep vein thrombosis (DVT) of the lower limbs during pregnancy remains controversial. There are a lot of problems related to anticoagulant therapy for the safety of the fetus; the use of caval filters rarely appears in the literature and it is not yet codified. So the choice of the right treatment is often difficult. The authors review their experience with a prophylactic use of a temporary caval filter for patients with proximal DVT of the last period of pregnancy, in order to avoid the inherent risk of major pulmonary embolism during delivery and postpartum. Methods: Ten women with proximal DVT were treated. The diagnosis was performed by Doppler ultrasonography (DU) and magnetic resonance (MR). At the end of pregnancy, a temporary caval filter (eight Prolyser and two Tempofilter) was percutaneously inserted under X-ray control. The patients were then subjected to a planned caesarean section. After 15 days, all filters were removed after a phlebography to check the absence of clots. Results: The mean time of X-ray exposure was about 1 min and 30 s. None of the patients suffered a major pulmonary embolism. All fetuses were born without problems or malformations. There were no complications related to the filters. No caval thrombosis or filters clots were found at the phlebography. The follow-up registered no pulmonary embolism episodes. Conclusions: The use of a temporary caval filter in pregnancy is safe and does not introduce any additional risk. It could be suggested for pregnant patients with proximal DVT beginning in the last period of pregnancy.

scholarly journals Percutaneous Thrombus Removal in COVID-19–Infected Patient with Pulmonary Embolism

2021 ◽  
Vol 17 (2) ◽  
pp. e33-e36
Author(s):  
Angelo Nascimbene ◽  
Sukhdeep Basra ◽  
Kha Dinh ◽  
Jayeshkumar Patel ◽  
Igor Gregoric ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Percutaneous Treatment ◽  
Vein Thrombosis ◽  
Left Lower Extremity ◽  
Transcatheter Aortic Valve ◽  
Thrombus Removal ◽  
The Right ◽  
In Transit ◽  
Deep Vein ◽  
Large Clot

We present a case describing the use of the AngioVac system (AngioDynamics, Inc.) and SENTINEL™ cerebral protection system (SCPS; Boston Scientific) in a patient with COVID-19 who initially presented with a large deep-vein thrombosis of the left lower extremity, complicated by a pulmonary embolism. Although he initially improved with systemic alteplase, he later developed a second large clot diagnosed in transit in the right atrium. Within 12 hours from initial thrombolysis, this large clot wedged across an incidental patent foramen ovale (PFO), the atrial septum, and the cavotricuspid annulus. We emergently performed a percutaneous clot extraction with preemptive placement of the SCPS in anticipation of cardioembolic phenomenon. A large (> 10 cm) clot was extracted without complication, and the patient was discharged home. The combined use of SCPS and AngioVac in this case suggests a potential role for percutaneous treatment of severe and consequential thromboembolic disease, especially in patients with a PFO, and may be considered as an alternative and less-invasive option in patients with COVID-19. While cerebral embolic protection devices are approved for and widely used in transcatheter aortic valve replacement procedures, there is a theoretical benefit for use in percutaneous thrombolectomies as well.

scholarly journals Thrombosis in Rheumatological Diseases

2021 ◽  
pp. 263-289
Author(s):  
Fozya Bashal
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Venous Thrombosis ◽  
Blood Coagulation ◽  
Thirteenth Century ◽  
Vein Thrombosis ◽  
The Right ◽  
Deep Vein ◽  
Rheumatological Diseases

AbstractVenous thromboembolism (VTE) is a disease of blood coagulation that occurs in the veins, most often in the calf veins first, from where it may extend and cause deep vein thrombosis (DVT) or pulmonary embolism (PE). The first described case of venous thrombosis that we know of dates back to the thirteenth century, when deep vein thrombosis was reported in the right leg of a 20-year-old man [1].

scholarly journals Coagulopathy in COVID-19 infection: a case of acute upper limb ischemia

2020 ◽  
Vol 2020 (6) ◽  
Author(s):  
Nikiforos Galanis ◽  
Chara Stavraka ◽  
Filon Agathangelidis ◽  
Evangelos Petsatodis ◽  
Christos Giankoulof ◽  
...  
Keyword(s):  
Upper Limb ◽  
Severe Infection ◽  
Limb Ischemia ◽  
Axillary Vein ◽  
The Novel ◽  
Vein Thrombosis ◽  
Treatment Dose ◽  
The Right ◽  
Deep Vein ◽  
Severe Coagulopathy

Abstract Coagulation abnormalities and thrombosis have been recently identified as sequelae of severe infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report a case of severe coagulopathy manifesting with right upper limb arterial and deep vein thrombosis in an 80-year-old male patient with severe COVID-19 associated pneumonia. He clinically deteriorated and received care in the intensive care unit where he was intubated. At that point, his coagulation laboratory tests were deranged, and he eventually developed dry gangrene in his right thumb and index finger, as well as a deep venous thromboembolism in his right axillary vein. Despite receiving treatment dose anticoagulation and undergoing arterial embolectomy, revascularization was unsuccessful. Amputation of the right arm at the level of the elbow was considered, but the patient died from respiratory failure.

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