1/16. Peripheral arterial embolism originating from a thrombus in the ascending aorta.A 45-year-old man experienced arterial thromboembolism to the right leg requiring surgical restoration of blood flow. Transesophageal echocardiography (TEE) was performed to determine the source of embolism and identified a localized atherosclerotic lesion in the distal ascending aorta with an adherent, highly mobile thrombus. The patient underwent surgery with removal of the atherosclerotic plaque and attached thrombus, and resection of the adjacent aortic wall. This case illustrates an unusual location for a complex atherosclerotic lesion in the ascending aorta, and points out the opportunity for remedial surgery once a symptomatic embolus has occurred.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
2/16. Intracoronary thrombolysis and intraaortic balloon counterpulsation for the emergency treatment of probable coronary embolism after repair of an acute ascending aortic dissection.IMPLICATIONS: This report shows that if diffuse coronary thromboembolism is encountered during ascending aortic dissection-repair, the option of combining single-bolus, intracoronary thrombolysis with intraaortic balloon counterpulsation should be considered.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
3/16. Bilateral intermittent claudication and the aorta.With the increasing utilization of imaging strategies such as transesophageal echocardiography and magnetic resonance imaging, thrombi of the aorta are becoming increasingly recognized as sources of peripheral emboli. This report describes a 70-year-old man with bilateral intermittent claudication. Arteriography revealed occlusion of the distal part of the right tibialis posterior artery and the left tibialis anterior artery, but no occlusive atherosclerotic disease of the iliac, femoral, or popliteal artery. Additionally, no calcification of the vessels could be demonstrated. In contrast, a giant thrombus of the descending aorta was identified as the source of systemic thromboembolism. The patient was treated successfully with long-term anticoagulation.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
4/16. A case of vasospastic angina resulting from coronary emboli in a patient with prosthetic valves.In addition to coronary atherosclerotic disease, coronary thromboembolism can also lead to acute coronary syndromes. However, coronary thromboembolism due to prosthetic heart valves is very rare and not very well-known. It have been reported only a few cases. In this paper, we present a rare case with vasospastic angina pectoris secondary to coronary thromboembolism in a patient with prosthetic heart valves.- - - - - - - - - - ranking = 3keywords = thromboembolism (Clic here for more details about this article) |
5/16. Prolonged low-dose intravenous thrombolysis in a stroke patient with distal basilar thrombus.BACKGROUND AND PURPOSE: patients with high-grade basilar artery stenosis secondary to thromboembolism are at high risk of developing subsequent vessel occlusion. Optimal medical management of this condition is unclear. SUMMARY OF CASE: We present a patient with a small subacute brain stem infarction and filiform distal basilar residual lumen attributable to arterioarterial or cardiogenic embolism. Beginning 3 days after symptom onset, low-dose intravenous thrombolysis with 0.125 mg/kg recombinant tissue plasminogen activator was continuously infused for 48 hours. Follow-up magnetic resonance angiography revealed complete resolution of the embolus. No further cerebral ischemic episodes occurred during 3-month follow-up, and the basilar artery remained patent. CONCLUSIONS: Our observation suggests a potential for prolonged low-dose intravenous thrombolysis in basilar artery embolism, but further data are needed to judge the effectiveness and risk of this intervention.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
6/16. Arterial thrombosis and embolism in malignancy.In most reviews of arterial embolism or thrombosis the source of emboli or the cause of thrombosis can reasonably be established in over 90% of patients. Still about 10% remain without demonstrable cardiac or intraarterial sources. Although hypercoagulability induced by malignancy has been alluded to as a cause of unexplained intravascular thrombosis reports of arterial thromboembolism with such association are rare. Seven patients with unequivocal thromboembolism are presented. Two distinct clinical patterns are observed, one with in situ thrombosis of small arteries and the other with occlusion of large arteries causing limb ischemia or fatal organ infarction. The various pathogenetic mechanisms of arterial thrombosis or embolism in malignancy include sustained spasm of arteries, precipitation of cryoglobulins or other abnormal proteins in small arteries, direct tumor invasion of arteries, fragmentation and embolization of intracardiac or intraarterial metastases and spontaneous arterial thrombosis due to hypercoagulability. The hypercoagulable state can be recognized by the observation of shortened bleeding and clotting times, partial thromboplastin and prothrombin times, elevation of coagulation factors, platelets and yield stress index and resistance to anticoagulation. patients presenting with arterial thromboembolic events with out demonstrable source should be investigated for malignancy. Conversely patients with malignancy should be searched for evidence of hypercoagulability in an attempt to prevent arterial thromboembolic complications.- - - - - - - - - - ranking = 2keywords = thromboembolism (Clic here for more details about this article) |
7/16. Acute anterior myocardial infarction complicated by mural thrombus and peripheral thromboembolism despite anticoagulation.A 43-year-old man had transmural anterior wall myocardial infarction complicated by hypotension and anterior-apical aneurysmal formation. Despite continuous anticoagulation with heparin sodium (heparin) and warfarin sodium (coumadin), a large pedunculated left ventricular thrombus was formed. Four hours after uneventful left ventriculography, the patient experienced acute superior mesenteric embolism. An emergency mesenteric embolectomy and then left ventricular aneurysmectomy with clot evacuation were performed to save the bowel and to prevent further embolization.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
8/16. Fat and thromboembolism after total hip replacement.Three patients who died after total hip replacement were subjected to a necropsy examination. The object of this was to determine whether there was any evidence of a relationship between fat emboli produced by the surgery and thrombotic complications. All three patients showed extensive fat embolisation in the lungs and antemortem thrombosis. In two of these the morphological relationship between these two phenomena was such that it seems likely that the fat emboli preceded and caused the thrombosis.- - - - - - - - - - ranking = 4keywords = thromboembolism (Clic here for more details about this article) |
9/16. Embolus to the right atrium simulating myxoma.A space-occupying mass of the right atrium was found by two-dimensional echocardiography and angiography in a 68-year-old woman whose clinical diagnosis indicated multiple pulmonary emboli. Since right heart myxomas frequently cause pulmonary thromboembolism, the patient was initially diagnosed by noninvasive and invasive techniques as having a right atrial myxoma. Surgery, however, revealed the pathologic findings of large thrombi of the right atrium, femoral and iliac veins, and pulmonary arteries. This case vividly demonstrates that deep venous thrombosis may embolize and lodge in the right atrial cavity simulating a right atrial myxoma.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
10/16. Massive spinal cord infarction with multiple paradoxical embolism: a case report.A sixty-seven-year-old man suffered from acute anterior spinal artery syndrome at the level of T-10. Transverse myelopathy developed by the eighth day. Computed tomography of the brain on the thirteenth day demonstrated hemorrhagic infarction in the left occipital lobe and fresh ischemic infarction in the right cerebellar hemisphere. Respiratory distress was the cause of death on the fifteenth day. autopsy study showed severe ischemic necrosis of the spinal cord below T-10, and multiple infarcted lesions in the brain, lung, kidney, and heart. Saddle thromboembolism of the bilateral trunk of the pulmonary artery was the major cause of his death. Deep venous thrombosis in the pelvis was disclosed to be the primary source of multiple paradoxical embolisms through the patent foramen ovale.- - - - - - - - - - ranking = 1keywords = thromboembolism (Clic here for more details about this article) |
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