scholarly journals Acute limb ischemia by a pulmonary vein stump thrombus after left lower lobectomy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuri Fujimoto ◽  
Ryosuke Hamachi ◽  
Yoshimasa Motoyama ◽  
Etsuko Kanna ◽  
Masako Murakami ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Thrombus Formation ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Common Symptom ◽  
Acute Limb Ischemia ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Enhanced Computed Tomography ◽  
Pulmonary Vein Stump

Abstract Background Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy. Case presentation A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications. Conclusions Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.

Acute Limb Ischemia

2012 ◽  
Author(s):  
Jovan N. Markovic ◽  
Cynthia K. Shortell
Keyword(s):  
Clinical Evaluation ◽  
Bypass Graft ◽  
Limb Ischemia ◽  
Heparin Therapy ◽  
Common Symptom ◽  
Acute Limb Ischemia ◽  
Graft Occlusion ◽  
Surgical Embolectomy

Acute limb ischemia (ALI) is one of the most challenging conditions in vascular surgery and carries a high risk of amputation and mortality when treatment is delayed. Limb ischemia occurs when there is abrupt interruption of blood supply to an extremity because of either embolic or in situ thrombotic arterial or bypass graft occlusion. The goals of management include limb salvage, minimization of morbidity, and prevention of death. However, given that no objective markers of limb viability are currently available, the initial determination of whether a limb is likely to be viable must be made on clinical grounds. An early clinical evaluation is crucial for the diagnosis and identification of the underlying etiology of the ALI. As ALI is a clinical diagnosis, this review describes all aspects of the clinical evaluation as essential: patient history, staging of limb ischemia, and investigative studies. Atheromatous embolization is also discussed in depth. The characteristic signs of ALI may be summarized as the “six p’s”: pulselessness, pain, pallor, poikilothermia, paresthesia, and paralysis. Pain is the most common symptom in an ischemic limb and progresses along with the ischemia. As ischemia continues to progress, severe pain can be replaced by anesthesia of the limb, which can confound the examiner. Thus, pain should be documented with regard to severity, localization, and progression. ALI therapies covered are heparin therapy, thrombolytic therapy, thrombectomy, and surgical embolectomy and revascularization. The pathophysiology of limb ischemia is related to the progression of tissue infarction and irreversible cell death. Compared with other organs and tissues (e.g., the brain and the heart), the extremities are relatively resistant to ischemia. However, the various tissue types of which an extremity is composed have different metabolic rates. This review has 2 figures, 6 tables, and 165 references.

When is urokinase treatment an effective sole or adjunctive treatment for acute limb ischemia secondary to native artery occlusion?

1999 ◽  
Vol 178 (2) ◽  
pp. 103-106 ◽  
Author(s):  
William D Suggs ◽  
Jacob Cynamon ◽  
Brian Martin ◽  
Luis A Sanchez ◽  
Samuel I Wahl ◽  
...  
Keyword(s):  
Limb Ischemia ◽  
Artery Occlusion ◽  
Adjunctive Treatment ◽  
Acute Limb Ischemia ◽  
Native Artery

scholarly journals Cystic Adventitial Disease of the Common Femoral Artery: A Rare-Case Report

2022 ◽  
Vol 8 ◽  
Author(s):  
Qilong Wang ◽  
Zhihua Cheng ◽  
Liang Tang ◽  
Qi Wang ◽  
Ping Zhang ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Limb Ischemia ◽  
Common Femoral Artery ◽  
Acute Limb Ischemia ◽  
Appropriate Treatment ◽  
Contrast Enhanced ◽  
Rare Case Report ◽  
The Right ◽  
Enhanced Computed Tomography

Herein, we report the case of a 59-year-old man with intermittent claudication of ~100 m, who complained of resting pain in his lower right extremity. A pelvic, contrast-enhanced, computed tomography scan showed the presence of cystic density in the lower segment of the right common femoral artery. Faced with the risk of acute limb ischemia, we navigated a challenging diagnostic procedure to choose an appropriate treatment for him. Additionally, we performed a pathological investigation of the excised common femoral artery following the excision bypass. On postoperative day 5, the patient was discharged from the hospital. During the 2-year follow-up, no new cysts were discovered, and the patient had favorable prognosis.

scholarly journals P3.04-004 The Risk Factor of the Thrombus Formation in Pulmonary Vein Stump after Left Upper Lobectomy for Lung Cancer

2017 ◽  
Vol 12 (1) ◽  
pp. S1386-S1387 ◽  
Author(s):  
Reiko Shimizu ◽  
Shoko Hayashi ◽  
Kiyomichi Mizuno ◽  
Yoshiyuki Yasuura ◽  
Hiroyuki Kayata ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Risk Factor ◽  
Pulmonary Vein ◽  
Thrombus Formation ◽  
Left Upper Lobectomy ◽  
Pulmonary Vein Stump

scholarly journals Thrombus Formation in the Pulmonary Vein Stump after Left Upper Lobectomy: A Report of Four Cases

2014 ◽  
Vol 20 (Supplement) ◽  
pp. 613-616 ◽  
Author(s):  
Hideo Ichimura ◽  
Yuichiro Ozawa ◽  
Hidetaka Nishina ◽  
Seiji Shiotani
Keyword(s):  
Pulmonary Vein ◽  
Thrombus Formation ◽  
Left Upper Lobectomy ◽  
Pulmonary Vein Stump

Video-assisted left lower lobectomy with intrapericardial pulmonary vein isolation

2020 ◽  
Keyword(s):  
Pulmonary Vein ◽  
Lower Lobe ◽  
Radical Resection ◽  
Hemodynamic Instability ◽  
Uneventful Recovery ◽  
Thoracoscopic Approach ◽  
Video Tutorial ◽  
Inferior Pulmonary Vein ◽  
Lower Lobectomy ◽  
Operative Planning

The thoracoscopic approach to lobectomy is now the gold standard in cases of pulmonary malignancies because it is associated with a significant reduction in both postoperative hospital stay and pain. Even in cases of complex resection, as in the case reported here, the procedure can be performed safely after careful pre-operative planning. This video tutorial describes our technique for the intrapericardial isolation of the left inferior pulmonary vein in a patient affected by a left lower lobe metastasis from a colonic carcinoma. The lesion was retracting the inferior vein to such an extent that an intrapericardial approach was required in order to obtain a radical resection. The operation was carried out using a 3-port technique to allow for safe and unhindered manipulation of the hilar structures and the parenchyma. The pericardial sac was easily opened and the feasibility of the procedure was readily confirmed. The patient made an uneventful recovery; specifically, we did not record any arrhythmia or hemodynamic instability. She was discharged home on the 4th postoperative day.

scholarly journals Intracardiac Thrombosis and Multiple Arterial Thromboembolism with Acute Limb Ischemia: A Rare Complication of Carbon Monoxide Intoxication

2017 ◽  
Vol 28 (02) ◽  
pp. 147-150
Author(s):  
B. Benfor ◽  
R. Hajji ◽  
A. Bouarhroum ◽  
Y. Lagdrori ◽  
Brahim Boukatta ◽  
...  
Keyword(s):  
Carbon Monoxide ◽  
Recent Literature ◽  
Thrombus Formation ◽  
Rare Complication ◽  
Limb Ischemia ◽  
Renal Infarction ◽  
Acute Limb Ischemia ◽  
Co Poisoning ◽  
Arterial Thromboembolism ◽  
Intracardiac Thrombosis

AbstractCarbon monoxide (CO) poisoning is a very common reason for emergency ward admission, with symptoms varying from a simple headache and dizziness to severe neurological and cardiac impairment. We report here a rare clinical presentation of CO intoxication manifested by a severe cardiac impairment with intracardiac thrombus formation, acute limb ischemia, renal infarction, and carotid artery thrombosis. There have been initial reports of thromboembolic events in acute CO poisoning with intracardiac thrombosis being sparsely reported. Contrary to venous thromboembolism, arterial thromboembolism in CO poisoning seems to be extremely rare. To the best of our knowledge, this is the first report in recent literature of a combined intracardiac thrombosis and multiple arterial thromboembolism induced by CO poisoning.

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