Ghorbanzadeh Atefeh, Bendel Emily C, Houghton Damon E
Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Brain Circ. 2024 Jul 15;11(1):86-88. doi: 10.4103/bc.bc_115_23. eCollection 2025 Jan-Mar.
Paradoxical embolism represents a critical and potentially fatal complication that can be associated with pulmonary embolism (PE). This case details a unique case of massive PE, further complicated by embolic stroke occurring during catheter-directed thrombolytic therapy. There was no evidence of thrombosis during the initial evaluation with lower extremity Doppler ultrasound, abdominal computed tomography scan, and transthoracic echocardiography. Differentials for the source of the emboli include unrecognized left atrial appendage thrombus, pulmonary arteriovenous malformations, and a patent left foramen ovale. Our findings highlight the complexities and treatment challenges of massive PE.
反常栓塞是一种严重且可能致命的并发症，可与肺栓塞（PE）相关。本病例详细介绍了一例独特的大面积PE病例，在导管定向溶栓治疗期间并发栓塞性中风，使病情更加复杂。在最初的评估中，下肢多普勒超声、腹部计算机断层扫描和经胸超声心动图均未发现血栓形成。栓子来源的鉴别诊断包括未被识别的左心耳血栓、肺动静脉畸形和卵圆孔未闭。我们的研究结果突出了大面积PE的复杂性和治疗挑战。
