Cases reported "Embolism, Paradoxical"

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1/26. Inverse paradoxical embolism in a patient on chronic hemodialysis with aortic bacterial endocarditis.

    We present a 45-year-old patient on chronic hemodialysis who suffered aortic endocarditis by staphylococcus haemolyticus after bacteremia associated with a venous catheter, which was used temporarily during the maturing phase of a Cimino-Brescia arteriovenous fistula in the left forearm. Three weeks after starting antibiotic therapy, the patient suffered a septic pulmonary embolism. The catheter had been removed 4 weeks before the embolism. thrombophlebitis of lower limbs, infection or thrombosis of the vascular access, and the involvement of right-sided cardiac structures were all discarded. We assumed that the pulmonary episode was probably a consequence of the paradoxical passage of embolic material, detached from the aortic valve, from arterial to venous circulation through the arteriovenous fistula.
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ranking = 1
keywords = thrombosis
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2/26. Paradoxical embolism-report of a case involving four organ systems.

    Paradoxical embolism through a patent foramen ovale (PFO) can involve multiple organs simultaneously. The most commonly involved sites are the cerebrum and the extremities. Paradoxical embolism to coronary arteries or upper extremities is relatively uncommon. We report a case of acute pulmonary embolism and paradoxical embolism through a patent foramen ovale involving the left upper extremity, brain, and coronary artery. early diagnosis in the emergency department was made by a trans-esophageal echocardiogram, and the patient was successfully treated with intravenous t-PA and heparin. patients with acute pulmonary embolism or deep venous thrombosis who also develop signs of systemic embolism should be evaluated for a patent foramen ovale.
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ranking = 2.0305682934596
keywords = venous thrombosis, thrombosis, deep
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3/26. Paradoxical cerebral air embolism after removal of a central venous catheter: case report.

    Paradoxical cerebral air embolization through a residual tract after the removal of a central venous catheter is a serious complication of central venous cannulation. air embolisms resulting from residual catheter tracts in general patients and in single lung transplant patients have been reported. The generally accepted mechanism of this complication is failure of a spontaneous collapse or thrombotic obliteration of a well-formed catheter tract. It may be related to the duration of catheter insertion, the patient's nutritional status, the diameter of the indwelling catheter, the upright position of the patient, deep inspiration or coughing, and improper wound dressing and catheter removal. Cardiovascular collapse, pulmonary or neurologic sequelae, and even death, are commonly noted in patients with air embolism. In this article, we report on cerebral air embolization as a complication with the removal with a central venous catheter in a patient with bullous emphysema. A high degree of suspicion and a prompt diagnosis are required for successful application of established therapy. Simple prophylactic procedures and constant awareness of the unusual mechanism of air embolism remain the best treatment.
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ranking = 0.016251294959261
keywords = deep
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4/26. The successful surgical treatment of a paradoxical embolus to the carotid bifurcation.

    Paradoxical embolism is a rare cause of ischemic stroke. We report the case of a 67-year-old man who had a saddle embolus to the carotid bifurcation successfully treated with emergency embolectomy. Transesophageal echocardiogram revealed a large patent foramen ovale and an easily demonstrable right-to-left shunt. Subsequent investigations revealed proximal deep venous thrombosis in the left femoral and popliteal veins and multiple pulmonary emboli. Long-term anticoagulation was instituted for the diagnosis of paradoxical embolism. The patient's recovery was uneventful, and he remained neurologically intact. A literature review emphasizes the role of transesophageal echocardiography and suggests that paradoxical embolism may be a more common cause of stroke than previously thought.
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ranking = 2.0516311019369
keywords = venous thrombosis, thrombosis, vein, deep
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5/26. Paradoxical embolism. An old but, paradoxically, under-estimated problem.

    The theoretical model of paradoxical embolism requires the presence of four parameters, namely, arterial embolism, venous thrombus, abnormal intracardiac communication and right-to-left shunt. Many aspects, however, of this well known entity are under consideration; diagnosis is often difficult to be established and the long term efficacy of preventive measures is undefined. We comment on a case report of recurrent paradoxical embolism with popliteal vein thrombosis and patent foramen ovale, and we briefly review the literature.
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ranking = 1.0968324820838
keywords = thrombosis, vein thrombosis, vein
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6/26. Patent foramen ovale complicated by paradoxical embolism and brain infarct in a patient with advanced ovarian cancer.

    BACKGROUND: Recent investigations of patients with cerebral and peripheral arterial emboli of unknown cause suggest that paradoxical embolism through a patent foramen ovale might be responsible for more arterial embolic events than previously realized. CASE: A 60-year-old woman with advanced ovarian cancer presented with sudden onset of expressive aphasia and right upper hemiplegia postoperatively. A patent foramen ovale diagnosed by echocardiography with contrast combined with the presence of thrombosis in her right femoral vein leads us to speculate that her stroke was secondary to a paradoxical embolism. CONCLUSION: Paradoxical embolism should be considered in the differential diagnosis of ovarian cancer patients with embolic stroke and it may be appropriate to include a cardiac echo as part of the diagnostic evaluation.
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ranking = 1.0210628084773
keywords = thrombosis, vein
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7/26. 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.
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ranking = 5.3396436183838
keywords = deep vein, deep vein thrombosis, thrombosis, vein thrombosis, vein, deep
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8/26. Intracardiac thrombus traversing a patent foramen ovale: impending paradoxical embolism demonstrated by transoesophageal echocardiography.

    Paradoxical embolism is a rare but potentially catastrophic complication of deep venous thromboses and pulmonary embolism. We describe a patient in whom transoesophageal echocardiography demonstrated a large clot traversing the atrial septum which was successfully removed by surgery.
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ranking = 0.016251294959261
keywords = deep
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9/26. Paradoxic aortic arch embolization with occlusion of the supraaortic arteries.

    Pulmonary embolization usually occurs when thrombotic material that originates from deep venous thrombosis of the lower extremities is washed out into the pulmonary vasculature via the blood stream. However, in the presence of a patent foramen ovale (PFO), systemic paradoxic embolization may also occur (Am J Surg 176 (1998) 158). Here, we report on the case of a patient with a PFO, who developed paradoxic embolization of the aortic arch following deep venous thrombosis and massive pulmonary embolism.
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ranking = 4.0611365869191
keywords = venous thrombosis, thrombosis, deep
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10/26. Thrombus-in-transit and paradoxical embolism.

    Paradoxical embolism is an uncommon but clinically important phenomenon. elements of diagnosis include the presence of: (1) a venous thrombus, (2) an arterial embolus, (3) a communication between the right and left heart, and (4) a thrombus traversing such a communication. Unfortunately, all of these elements can be rarely demonstrated in each case but the probability should be considered in any patient with 2 or more present. It should be suspected in patients who have evidence of systemic arterial emboli without apparent cause. A transesophageal echocardiogram with contrast should be considered in cases where paradoxical embolism is a possibility. We present a case in which a "thrombus-in-transit" was imaged across the interatrial septum in a patient with a patent foramen ovale, deep venous thrombosis, and an embolic cerebrovascular stroke.
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ranking = 2.0305682934596
keywords = venous thrombosis, thrombosis, deep
(Clic here for more details about this article)
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