Thromboembolism-in-transit, specifically impending paradoxical embolism (IPDE), is a rare and life-threatening condition with limited reported cases. We present a case of a 51-year-old male with obstructive sleep apnea, initially diagnosed with deep vein thrombosis and pulmonary embolism. Further evaluation revealed a saddle pulmonary embolus extending into the right atrium, straddling a patent foramen ovale (PFO), confirmed by transesophageal echocardiogram. Despite a critical left anterior descending coronary artery stenosis, surgical thrombectomy, PFO closure, and coronary artery bypass grafting were successfully performed. Thromboembolism-in-transit poses diagnostic challenges, and there is a lack of consensus on the optimal treatment strategy. Surgical interventions, including embolectomy and PFO closure, have shown promise, while thrombolytic therapy remains controversial. This case underscores the importance of tailored management in the absence of standardized guidelines, emphasizing the need for further research to establish evidence-based protocols for this uncommon but potentially fatal condition.
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http://dx.doi.org/10.1093/omcr/omae091 | DOI Listing |
Int J Cardiol Congenit Heart Dis
September 2024
Cardiology Department, La Paz University Hospital, Paseo de la Castellana, 261, 28046 Madrid, Spain.
Background: Obstructive complications in the Fontan circulation pose significant risks to affected patients. Traditional management strategies may be insufficient, necessitating innovative treatment approaches. This case report discusses the use of the FlowTriever Retrieval System for percutaneous aspiration thrombectomy in a patient with a history of Fontan procedure who developed conduit obstruction due to thrombus formation.
View Article and Find Full Text PDFJ Endovasc Ther
December 2024
Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Background: Pulmonary embolism (PE) is an important cause of death and disability. Advances in catheter-directed therapies have led to the use of devices, such as the Inari FlowTriever and Penumbra Indigo system for aspiration thrombectomy (AT) for both massive and sub-massive PE. However, limited data exist on causes of procedural mortality.
View Article and Find Full Text PDFAerosp Med Hum Perform
November 2024
Background: Arterial gas embolism (AGE) may occur while breathing compressed air and failing to exhale during ascent to compensate for gas expansion as pressure decreases. Trauma to the lungs from over-pressurization may result in air bubbles entering the pulmonary veins and subsequently the systemic circulation, causing obstructed blood flow and inflammatory cascades. AGEs are known to always manifest within 10 min of surfacing from depth.
View Article and Find Full Text PDFClin Appl Thromb Hemost
December 2024
Department of Hematology and Transfusion sciences, School of Allied Medical Sciences, Tehran University of Medical sciences, Tehran, Iran.
Objective: DNA methylation, as an epigenetic alteration, plays an essential role in the development of atherosclerosis and venous thrombosis. E-cadherin, a tumor suppressor gene and adhesion molecule, has a crucial function in platelet aggregation and hemostasis. P16, a cell cycle regulator, is involved in venous thrombosis.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
Background: This study aimed to develop predictive models with robust generalization capabilities for assessing the risk of pulmonary embolism in patients with tuberculosis using machine learning algorithms.
Methods: Data were collected from two centers and categorized into development and validation cohorts. Using the development cohort, candidate variables were selected via the Recursive Feature Elimination (RFE) method.
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