1/70. Pellet embolization to the right atrium following double shotgun injury.A 28-year-old man sustained two shotgun injuries of the left inguinal region from a distance of about 1.5 m by simultaneous discharge of both shells from a sawn-off double-barrelled 16-bore shotgun (diameter of the lead pellets, 4 mm). The first X-ray examination carried out soon after hospital admission showed a single embolized pellet near the right margin of the cardiac silhouette. Eight months later, the man committed suicide by drug intoxication. At autopsy, the embolized pellet was found embedded between the pectinate muscles of the right atrium. On the basis of the reported case and with reference to the pertinent literature, the paper points out the medico-legal aspects of venous bullet/pellet embolism and the risk of lead poisoning after shotgun injury.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
2/70. Central venous catheter-associated thrombosis in severe haemophilia.Significant subclavian vein thromboses associated with indwelling fully implanted (port-a-cath) devices are described in two boys with severe haemophilia A and factor viii inhibitors. Investigations were prompted by prominent chest wall veins in one case, whereas the thrombosis was a chance finding in the other case during investigation of mechanical dislocation of the catheter tubing. Extensive collateral venous circulations were demonstrated by venography in both instances indicating that the thrombus had been present for some time. Possible contributing factors to the thromboses included desensitization therapy (both patients), high-dose FEIBA (in one patient) and use of lower doses of heparin for line flush than that recommended by some authors. Neither patient had a familial or non-familial predisposition to thrombosis.- - - - - - - - - - ranking = 1.087471902155keywords = thrombosis (Clic here for more details about this article) |
3/70. pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty.A pulmonary embolus of acrylic cement was present in a 41-year-old woman with Langerhans' cell vertebral histiocytosis (LCH) after percutaneous vertebroplasty. Chest radiograph and CT confirmed pulmonary infarction and the presence of cement in the pulmonary arteries. She was treated with anticoagulants, and responded favorably. This rare complication occurred because perivertebral venous migration was not recognized during vertebroplasty. Adequate preparation of cement and biplane fluoroscopy are recommended for vertebroplasty.- - - - - - - - - - ranking = 4keywords = embolism (Clic here for more details about this article) |
4/70. fatal outcome in atrial migration of the Tempofilter.PURPOSE: To report the risk of fatal atrial migration with the Tempofilter. methods: Among temporary filters, the high safety profile Tempofilter has been marketed as offering protection for up to 6 weeks. We implanted about 60 Tempofilters to prevent pulmonary embolism. The main indications were temporary thromboembolic risk, recurrent pulmonary embolism, and contraindication to or failure of anticoagulant therapy. Follow-up was performed regularly by plain abdominal film and Doppler ultrasound. Filters were removed about 4 weeks after placement. RESULTS: We encountered three cases (5%) of atrial migration and one case of 5-cm cephalad displacement of the filter. Of the three patients with atrial migration, two died within 3 days of implantation, one from a massive pulmonary embolism and the other with cardiac tamponade. One patient did not show any serious complications. CONCLUSIONS: The Tempofilter may actively migrate cranially and become dangerous in the case of migration within the heart.- - - - - - - - - - ranking = 3keywords = embolism (Clic here for more details about this article) |
5/70. Aortoduodenal fistula: a late complication of intraluminal exclusion of an infrarenal aortic aneurysm.During recent years, considerable clinical experience has been gained with endoluminal stent-graft procedures. Several studies have shown promising results up to a period of 4.5 years. However, long-term follow-up studies are still limited. Late endoleaks caused by stent-graft migration, disconnection of single components in modular stent-grafts, and limb thrombosis have been observed as long-term complications. We report a case in which a migrated and kinked bifurcated stent-graft caused an aortoduodenal fistula 20 months after stent-graft insertion. To our knowledge, such a complication has not been reported before.- - - - - - - - - - ranking = 0.18124531702583keywords = thrombosis (Clic here for more details about this article) |
6/70. Embolism of a metallic clip: an unusual complication following laparoscopic cholecystectomy.A 32-year-old woman underwent laparoscopic cholecystectomy during which there was severe bleeding from the bed of the gallbladder. As application of metallic clips to control the bleeding was not successful, the operation was converted to an open laparotomy. cholecystectomy was successfully completed without further complications, and the post-operative course was uneventful and the patient was discharged. Eighteen months later, the patient complained of dyspnea. Plain radiograph and computed tomography of the thorax showed a metallic clip in the branch of the pulmonary artery supplying the posterior basal segment of the inferior lobe of the left lung. There was no connection between the patient's symptoms and the clip embolism. Nevertheless, clip migration or embolism could cause severe complications. Therefore, metallic clips should not be used to stop bleeding from the gallbladder bed.- - - - - - - - - - ranking = 2keywords = embolism (Clic here for more details about this article) |
7/70. Surgical management of a penetrated greenfield inferior vena cava filter.This is a case report of an IVC filter penetration identified during lymph-node dissection for endometrial carcinoma. Although the spread strut put the adjacent abdominal aorta in danger of penetration, surgical removal of the filter could not be performed because there was still an increased risk of pulmonary embolism. Instead of IVC interruption, we used a wrapping technique as a prophylaxis against major bleeding complication due to IVC filter dislocation and recurrent pulmonary embolism.- - - - - - - - - - ranking = 2keywords = embolism (Clic here for more details about this article) |
8/70. Delayed presentation of right ventricular bullet embolus.Venous bullet embolism to the heart is a rare complication of penetrating gunshot trauma. There are little data regarding long-term follow-up of missiles retained in the right ventricle. We report a rare case of right ventricular bullet embolus following a left-sided thoracic gunshot wound. The patient presented with delayed onset of cardiac irritability symptoms 4 years after injury.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
9/70. diagnosis of myocardial perforation by a Greenfield filter made by transesophageal echocardiography.Greenfield filters have been successfully used to prevent pulmonary embolism in selected patients. However, various complications have been described. A patient is presented in whom a Greenfield filter migrated to the right atrium, and subsequently perforated the right atrial wall. The diagnosis was made by transesophageal echocardiography and the filter removed surgically. This case emphasizes the role of transesophageal echocardiography in the management of migrated Greenfield filters.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
10/70. Repeated Gunther Tulip inferior vena cava filter repositioning to prolong implantation time.A patient presented with iliofemoral deep vein thrombosis, a small pulmonary embolism, and a paradoxic embolus to the axillary artery resulting from a patent foramen ovale (PFO). As prophylaxis against further paradoxic emboli while awaiting percutaneous PFO closure, a Gunther Tulip inferior vena cava (IVC) filter was implanted. To prevent incorporation of the IVC filter into the caval wall, it was repositioned twice with use of a filter retrieval set from a transjugular approach. In this way, the implantation time of the filter was extended beyond the recommended period of 10 days. The filter was successfully retrieved 19 days later during percutaneous closure of the PFO.- - - - - - - - - - ranking = 1.1812453170258keywords = embolism, thrombosis (Clic here for more details about this article) |
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