Left Upper Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction

Kobayashi, Yuya; Yahikozawa, Hiroyuki; Takamatsu, Ryota; Watanabe, Rie; Hoshi, Kenichi; Ishii, Wataru; Sato, Shunichi

doi:10.1016/j.jstrokecerebrovasdis.2017.06.034

Cited by 11 publications

(4 citation statements)

References 7 publications

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“…Such vascular conditions are conducive for thrombosis [ 24 ]. Cerebral embolism is usually caused by cardiogenic thrombosis [ 25 ]. The results of this study showed that 21.5% of patients with liver cirrhosis have a cerebral infarction.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study

Jiang

Zhai

et al. 2022

Computational and Mathematical Methods in Medicine

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Background. To explore the risk factors of gastrointestinal hemorrhage and/or cerebral infarction complications in liver cirrhosis and provide evidence for early prevention, clinical diagnosis, and treatment of liver cirrhosis. Methods. 200 liver cirrhosis patients were analyzed: liver cirrhosis ( n = 78 ), liver cirrhosis complicated with cerebral infarction ( n = 43 ), liver cirrhosis complicated with gastrointestinal hemorrhage ( n = 57 ), and liver cirrhosis complicated with gastrointestinal hemorrhage and cerebral infarction ( n = 22 ). The incidence of disease in each group of patients at different times was calculated. Multivariate logistic regression was used to analyze the risk factors of liver cirrhosis patients with gastrointestinal hemorrhage and cerebral infarction. After 12 months of follow-up, the mortality rate of each group was calculated. Results. The incidences of gastrointestinal hemorrhage, cerebral infarction, and gastrointestinal hemorrhage combined with cerebral infarction in patients with liver cirrhosis were 21.5%, 28.5%, and 11%, respectively. The width of the portal vein, D-2 polymer, albumin (ALB), and hemoglobin (Hb) were predictors of gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer were confirmed as risk factors for gastrointestinal hemorrhage and cerebral infarction in patients with liver cirrhosis. ALB and Hb were independent protective factors. Patients with liver cirrhosis and gastrointestinal hemorrhage with cerebral infarction had the worst survival. Conclusion. Age, hypertension, bleeding history, infection, portal vein width, and D-2 polymer are all independent risk factors for gastrointestinal bleeding and cerebral infarction, while ALB and Hb are independent protective factors.

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Section: Discussionmentioning

confidence: 99%

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study

Jiang

Zhai

et al. 2022

Computational and Mathematical Methods in Medicine

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“…Cerebral infarction can occur in acute "phase" (< 1 month) or chronic phase (> 6 months) after surgery. Kobayashi, Kitajima reported this complication occurs on the second postoperative day [6], [7]. Others declared in 6 months or later after surgery [8], [9].…”

Section: Discussionmentioning

confidence: 96%

Acute ischemic stroke after thoracoscopic lobectomy for the left upper lobe lung cancer: A case report

Son

Kiem

Viện

et al. 2021

YDLS

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Cerebral infarction is normally caused by thrombosis in chronic cardiogenic patients. However, it may be an acute appearance after surgery because of thrombus formation in dammaged vascular. The left upper lobectomy is the highest risk factor for cerebral infarction among anatomical lung resection. Here we report a 69-year-old patient who presented with left hemiparesis after left upper lung lobectomy on the fourth day. We strongly suspect that cerebral infarction is one of cardiopulmonary complications after anatomical lung resection in this case

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“…The turbulent blood flow in the PV stump is thought to contribute to thrombus development [3,[5][6][7][8]. LUL is considered a risk factor for cerebral infarction [9,10] although not all cases have shown thrombus formation within the PV stump [11,12]. As LUL usually leaves a longer PV stump than other types of lobectomy, blood stasis may occur more frequently in these regions and result in thrombus formation [3,5,6].…”

Section: Discussionmentioning

confidence: 99%

Successful Endovascular Treatment for Middle Cerebral Artery Occlusion Caused by the Thrombus Formation in the Pulmonary Vein Stump Following Left Upper Lung Lobectomy

Shiozaki¹,

Morofuji²,

Kawahara³

et al. 2021

Cureus

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Thrombus formation in the pulmonary vein (PV) stump after lung resection can cause rare cases of cerebral infarction. These infarctions can result in embolism and ischemia in the relatively large intracranial vessels, severely impacting the quality of life (QOL) of these patients. We performed endovascular thrombectomy successfully for this rare complication after lung lobectomy. A 73-year-old woman with paroxysmal atrial fibrillation (AF) suffered from sudden left complete hemiplegia 19 days after undergoing a left upper lung lobectomy (LUL). Magnetic resonance imaging (MRI) showed middle cerebral artery occlusion. Her left hemiplegia improved after the endovascular thrombectomy. Cardiogenic embolism was first suspected, but contrast-enhanced computed tomography (CECT) showed thrombus formation in the PV stump. We continued anticoagulant therapy, and the thrombus resolved completely two months after the stroke. Our patient had a relatively good outcome due to the immediate reperfusion of the affected area. This embolic source may be overlooked because AF frequently occurs after thoracic surgeries. Care should be taken during the postoperative phase to avoid overlooking these emboli. All thoracic surgeons should be informed about mechanical thrombectomy as an effective treatment for postoperative cerebral infarction.

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Left Upper Lung Lobectomy Is an Embolic Risk Factor for Cerebral Infarction

Cited by 11 publications

References 7 publications

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study

Prognostic Analysis of Liver Cirrhosis Patients with Cerebral Infarction and/or Gastrointestinal Hemorrhage: A Retrospective Cohort Study

Acute ischemic stroke after thoracoscopic lobectomy for the left upper lobe lung cancer: A case report

Successful Endovascular Treatment for Middle Cerebral Artery Occlusion Caused by the Thrombus Formation in the Pulmonary Vein Stump Following Left Upper Lung Lobectomy

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