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

Cardiovascular Ultrasound

Case Report

Adelaide Almeida¹  Igor Nunes¹  Sylvie Mariana¹  Nuno Cardim¹  Daniel Ferreira¹  José Roquette¹  Vanda Carmelo¹  Vanessa Carvalho¹  Júlia Toste¹  Francisco P Machado¹  Ana SN Oliveira²  José Ferro² 

[1] Cardiology Department, Hospital da Luz. Av. Lusíada, 100. 1500-650, Lisbon, Portugal;Neurology Department, Hospital da Luz. Av. Lusíada, 100. 1500-650, Lisbon, Portugal;

关键词: Central Venous Catheter;    Left Middle Cerebral Artery;    Paradoxical Embolism;    Cerebral Vascular Accident;    Atrial Septal Aneurysm;   

DOI  :  10.1186/1476-7120-8-6

 received in 2010-02-16, accepted in 2010-03-16,  发布年份 2010

来源: Springer

【 摘 要 】

Thromboembolism is a major cause of death in cancer patients. The association between paraneoplastic hypercoagulability of oncological patients and long-term central venous catheters (CVC) may result in CVC associated thrombosis. Patent Foramen Ovale (PFO), especially when associated with atrial septal aneurysm (ASA) is a risk factor for paradoxical embolism. We report a case of paradoxical embolism with stroke in an oncological patient with a huge CVC thrombus playing "ping-pong" with an hypermobile ASA with a PFO. We review the management of hypercoagulability in oncologic patients and discuss the potential role of routine transthoracic echocardiography before the implantation of long term central venous catheters to identify predisposing conditions to paradoxical embolism and select patients for anticoagulant therapy.

【 授权许可】

CC BY   
© Cardim et al; licensee BioMed Central Ltd. 2010