Deep venous thrombosis post mechanical thrombectomy in acute ischaemic stroke.

BMJ Case Rep

Department of Interventional Neuroradiology, The Royal London Hospital, London, UK.

Published: August 2023

A woman in her 20s presented with neck pain, slurred speech and left-sided weakness. She successfully underwent mechanical thrombectomy (MT) for total occlusion of the basilar artery and made full neurological recovery. Initial ultrasound Doppler of legs (USDL) did not show any deep vein thrombosis (DVT). However, 2 days later, a repeat USDL revealed an extensive proximal DVT in the right common femoral vein. CT scan confirmed a haematoma arising from the femoral access site causing compression of the adjacent common femoral vein. This may have initiated DVT formation or exacerbated extension of a previously undetected DVT. Echocardiogram revealed a patent foramen ovale. As the patient was asymptomatic, delayed or missed diagnosis of DVT would have put her at risk of life-threatening pulmonary embolism or further strokes. Clinicians should maintain a high index of suspicion of DVT as a direct procedural complication from MT so treatment can be initiated promptly.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10445379PMC
http://dx.doi.org/10.1136/bcr-2023-255391DOI Listing

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