Turnbull R G, Tsang V T, Teal P A, Salvian A J
Department of Surgery, University of British Columbia, Vancouver General Hospital, Canada.
J Vasc Surg. 1998 Oct;28(4):742-5. doi: 10.1016/s0741-5214(98)70106-5.
A 54 year-old man had symptoms of acute right hemispheric cerebral ischemia. He was initially considered for participation in a trial of early thrombolysis in stroke, but an innominate artery embolus was found with no apparent arterial source. The embolus was removed by means of a combined brachial and carotid bifurcation approach to protect the cerebral vasculature from embolic fragmentation during extraction. Further investigation revealed deep venous thrombosis, evidence of pulmonary emboli, and a patent foramen ovale, supporting a diagnosis of paradoxic embolus. Additional treatment included anticoagulation and placement of an inferior vena caval filter. The unusual condition of paradoxic embolus is reviewed, and the management of this patient is discussed.
一名54岁男性出现急性右半球脑缺血症状。他最初被考虑参与一项中风早期溶栓试验，但发现无名动脉有栓子，且无明显动脉来源。通过肱动脉和颈动脉分叉联合入路取出栓子，以在取出过程中保护脑血管免受栓子破碎的影响。进一步检查发现有深静脉血栓形成、肺栓塞证据及卵圆孔未闭，支持反常栓塞的诊断。额外的治疗包括抗凝及放置下腔静脉滤器。本文回顾了反常栓塞这一罕见病症，并讨论了该患者的治疗情况。
