Sonobe Shinya, Yoshida Masahiro, Niizuma Kuniyasu, Tominaga Teiji
Department of Neurosurgery, Osaki Citizen Hospital, Osaki, Miyagi, Japan.
Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
NMC Case Rep J. 2018 Dec 18;6(1):17-20. doi: 10.2176/nmccrj.cr.2018-0163. eCollection 2019 Jan.
Pulmonary vein thrombosis is a rare disease but can cause severe complications. However, pathophysiology of this entity is not fully understood. We report a case of mechanical thrombectomy for acute ischemic stroke arising from thrombus of the left superior pulmonary vein stump after left pneumonectomy. A 67-year-old male without atrial fibrillation presented with middle cerebral artery occlusion 11 days after left pneumonectomy. Contrast-enhanced computed tomography showed thrombus in the left superior pulmonary vein stump. He received mechanical thrombectomy and had a good postoperative course. The retrieved embolus was macroscopically red thrombus and histological examination revealed that the embolus consisted of fibrin and erythrocyte-rich thrombus. Thrombus formation in a pulmonary vein stump after lung resection may be an embolic source of AIS. Mechanical thrombectomy and anticoagulation is effective for the treatment of this pathology.
肺静脉血栓形成是一种罕见疾病，但可导致严重并发症。然而，该疾病的病理生理学尚未完全明确。我们报告一例因左肺切除术后左上肺静脉残端血栓形成导致急性缺血性卒中而行机械取栓术的病例。一名67岁无房颤男性在左肺切除术后11天出现大脑中动脉闭塞。增强计算机断层扫描显示左上肺静脉残端有血栓。他接受了机械取栓术，术后恢复良好。取出的栓子肉眼可见为红色血栓，组织学检查显示栓子由纤维蛋白和富含红细胞的血栓组成。肺切除术后肺静脉残端血栓形成可能是急性缺血性卒中的栓子来源。机械取栓术和抗凝治疗对该病理情况有效。
