Playing games with a thrombus: a dangerous match. Paradoxical embolism from a huge central venous cathether thrombus: a case report

Cardim, Nuno; Toste, Júlia; Carvalho, Vanessa; Nunes, Igor; Ferreira, Daniel; Carmelo, Vanda; Oliveira, Ana S N; Ferro, José M.; Mariana, Sylvie Da; Almeida, Ana C.; Machado, Francisco Pereira; Roquette, J

doi:10.1186/1476-7120-8-6

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…[26] Moreover, paraneoplastic hypercoagulability, chemotherapy and prolonged use of central venous catheters imply an increased risk of thromboembolism and consequently death. [27] The observation of a high mortality for non-neurological causes, also in our series, confirms that the modern treatments allow a significant control of the disease within the nervous system. Surgery entails the additional advantage of large tissue-samples availability for a detailed histological analysis that may influence targeted adjuvant therapies.…”

Section: Discussionsupporting

confidence: 85%

Surgery in cerebral metastases: Are numbers so important?

et al. 2014

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Our series included 242 patients: 105 had multiple MTS. Statistical analysis did not show significant differences in mean survival and outcomes between patients with single and multiple lesions. The decease occurred for neurological causes in 15.7% of cases. The selection of candidates for surgery requires several considerations and entails the success rate of this treatment. In patients with the multiple lesions who fulfilled the selection criteria we observed a nevertheless satisfying success after the operation. Our results imply that surgery may be applied also in selected patients with more diffuse intracranial disease. A pre-operative accurate patient selection is related to acceptable quality-of-life following the operation even in cases of multiple MTS.

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Section: Discussionsupporting

confidence: 85%

Surgery in cerebral metastases: Are numbers so important?

et al. 2014

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“…Intracardiac right‐to‐left shunting was demonstrated in 6 patients, while a pulmonary shunt was assumed in 9 patients. It has been shown that previously asymptomatic individuals may also harbor subtle right‐to‐left shunts, most commonly a patent foramen ovale (11%–35% of the healthy population) 6 , 9 , 10 . Paradoxical thromboembolism can occur through these shunts during hypercoagulable states.…”

Section: Discussionmentioning

confidence: 99%

Sudden‐Onset Bilateral Blindness in a Young Girl Receiving Parenteral Nutrition: Case Report and Review of Literature

Agarwal

Garg

Pal

et al. 2015

J Parenter Enteral Nutr

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“…Although paradoxical embolism through a PFO is a common cause of ischemic stroke, paradoxical embolic stroke associated with a central venous dialysis catheter (CVDC) is relatively uncommon and only a few cases among adult patients have been reported in the literature [7][8][9][10][11]. To the best of our knowledge, this is the first case of paradoxical embolism associated with the use of a tissue plasminogen activator (tPA) for unclogging a hemodialysis (HD) catheter.…”

Section: Introductionmentioning

confidence: 99%

Paradoxical Thromboembolic Ischemic Stroke Following Tissue Plasminogen Activator Instillation for Clogged Central Venous Dialysis Catheter

Nwosu¹,

Ibeson²,

Singh³

et al. 2021

Cureus

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Central venous catheters including dialysis catheters are a potential source of venous thrombosis and pose a risk for paradoxical embolic events including ischemic stroke and systemic embolism in patients with a patent foramen ovale (PFO). The adult population with a PFO and patients with a central venous dialysis catheter (CVDC) are at increased risk of a paradoxical embolic event. Since bubble study is not routinely done during echocardiogram in a patient with CVDC, it is difficult to identify at-risk patients for paradoxical embolic events during catheter manipulation, especially for clogged CVDC.We report a rare case of a 79-year-old lady with end-stage renal disease on hemodialysis (HD) using a CVDC who developed a paradoxical embolic ischemic stroke following the use of tissue plasminogen activator (tPA) for unclogging a dialysis catheter. We aimed to highlight the existing risks of thromboembolism associated with the long-term use of central CVDC, especially the potential risk of paradoxical embolism and ischemic stroke with the use of tPA for management of clogged dialysis catheters. We emphasize the questionable need for a bubble study echocardiogram in all patients requiring long-term dialysis catheters.

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Playing games with a thrombus: a dangerous match. Paradoxical embolism from a huge central venous cathether thrombus: a case report

Cited by 9 publications

References 15 publications

Surgery in cerebral metastases: Are numbers so important?

Surgery in cerebral metastases: Are numbers so important?

Sudden‐Onset Bilateral Blindness in a Young Girl Receiving Parenteral Nutrition: Case Report and Review of Literature

Paradoxical Thromboembolic Ischemic Stroke Following Tissue Plasminogen Activator Instillation for Clogged Central Venous Dialysis Catheter

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