Right heart thrombus in transit clot (RHTT) associated with a pulmonary thromboembolism (PTE) is a rare but potentially fatal diagnosis. Early diagnosis and immediate intervention are crucial. This report describes the case of a healthy, physically active 32-year-old female who presented 19 days postoperatively, following an anterior cruciate ligament reconstruction and partial lateral meniscectomy with a saddle PE, RHTT, and right ventricular (RV) strain. The patient received half of the standard dose of intravenous tissue plasminogen activator (TPA) in combination with anticoagulation and survived. Case reports of RHTT will inform future studies designed to evaluate whether and when thrombolysis should be administered.
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http://dx.doi.org/10.1155/2020/7561986 | DOI Listing |
Cureus
December 2024
Internal Medicine Department, Hospital Beatriz Ângelo, ULS Loures Odivelas, Loures, PRT.
Plasminogen activator inhibitor-1 (PAI-1) is central to fibrinolysis regulation, and genetic variants such as the 4G/4G genotype predispose individuals to hypercoagulability. This case highlights a 46-year-old female patient presenting with acute mesenteric venous thrombosis, where genetic evaluation revealed homozygosity for the PAI-1 4G/4G polymorphism. Management with unfractionated heparin followed by a transition to direct oral anticoagulants led to clinical resolution.
View Article and Find Full Text PDFJ Community Hosp Intern Med Perspect
November 2024
Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Intracardiac masses are rare and potentially life-threatening entities with diverse clinical presentations. The prompt identification of cardiac masses is critical. However, even with the advancement we have in imaging modalities, diagnosing cardiac masses remains a formidable challenge.
View Article and Find Full Text PDFRen Fail
December 2025
Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Objectives: Vascular access thrombosis (VAT) is a common complication in patients with end-stage renal disease (ESRD), significantly impacting hemodialysis efficacy and patient survival. Currently, temporary dialysis access is typically established deep vein catheterization (VC), however, this method is highly invasive and associated with risks of infection and other complications. This study aims to explore the feasibility of using direct anastomosis indwelling needle puncture (DAINP) for temporary dialysis access.
View Article and Find Full Text PDFAnn Ital Chir
January 2025
Institute of Central Nervous System Vascular Injury and Repair, Jining Medical Science Research Institute, The First People's Hospital of Jining, 272000 Jining, Shandong, China.
Aim: This study aims to report a rare case of an embolization protection device (EPD) entrapment during Carotid Artery Stent (CAS) and to discuss the management strategy, including open surgery and concurrent carotid endarterectomy (CEA).
Case Presentation: A 71-year-old female presented with left limb weakness and unclear speech following CAS. Imaging revealed a new cerebral infarction and right internal carotid artery stenosis.
Cardiovasc Drugs Ther
January 2025
Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, The Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangzhou, Guangdong Province, China.
Purpose: Coronary endarterectomy combined with coronary artery bypass grafting (CE-CABG) effectively achieves coronary revascularization in patients with diffuse atherosclerotic coronary artery disease (CAD). However, the loss of the subendothelial tissue at the CE-CABG coronary artery accelerates local thrombosis, leading to CE-CABG graft failure. Dual antiplatelet therapy (DAT) and warfarin plus aspirin (WPA) are the two most common anticoagulation strategies post CE-CABG.
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