Liu Yanan, Xie Yiyun, Lai Zhichao, Ye Wei, Shao Jiang, Liu Bao
Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
J Vasc Surg Cases Innov Tech. 2025 Jul 7;11(5):101910. doi: 10.1016/j.jvscit.2025.101910. eCollection 2025 Oct.
A 32-year-old man presented with acute pulmonary embolism, deep vein thrombosis, and lower extremity arterial ischemia after prolonged driving. He underwent emergency thrombolysis, thrombectomy, and inferior vena cava filter placement, and potential intra-atrium shunt was detected during the angiography. Postoperative recovery showed improved oxygenation and limb perfusion. Follow-up confirmed a right-to-left shunt via a patent foramen ovale, causing paradoxical embolism. In this article, we report and analyze this specific case. Additionally, we conduct a comprehensive review of the literature pertaining to patent foramen ovale and paradoxical embolism. Based on these insights, we propose the treatment principles for paradoxical embolism.
一名32岁男性在长时间驾车后出现急性肺栓塞、深静脉血栓形成和下肢动脉缺血。他接受了紧急溶栓、血栓切除术和下腔静脉滤器置入术，血管造影期间检测到可能存在的心房内分流。术后恢复显示氧合和肢体灌注得到改善。随访证实通过卵圆孔未闭存在右向左分流，导致反常栓塞。在本文中，我们报告并分析了这一特殊病例。此外，我们对与卵圆孔未闭和反常栓塞相关的文献进行了全面综述。基于这些见解，我们提出了反常栓塞的治疗原则。
