Paradoxical Peripheral Embolism Coincident with Acute Pulmonary Thromboembolism

Tatsuyuki INOUE; Futoshi TADEHARA; Toshihide HINOI; Shuji TSUJIYAMA; Shusuke MATSUO; Takeshi SHICHIJO; Tetsuya ONO; Michio YAMAKIDO

doi:10.2169/internalmedicine.44.243

CASE REPORTS

Paradoxical Peripheral Embolism Coincident with Acute Pulmonary Thromboembolism

Tatsuyuki INOUE, Futoshi TADEHARA, Toshihide HINOI, Shuji TSUJIYAMA, Shusuke MATSUO, Takeshi SHICHIJO, Tetsuya ONO, Michio YAMAKIDO

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Keywords: paradoxical peripheral embolism, acute pulmonary embolism, permanent inferior vena cava filter

JOURNAL OPEN ACCESS

2005 Volume 44 Issue 3 Pages 243-245

DOI https://doi.org/10.2169/internalmedicine.44.243

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Abstract

Paradoxical embolism may occur in patients with acute pulmonary thromboembolism, when patent foramen ovale (PFO) coexists with pulmonary hypertension (right-left shunt). There have been few case reports of paradoxical embolism in peripheral arteries coincident with acute pulmonary thromboembolism. Here, we describe a case of paradoxical peripheral embolism associated with PFO complicated by acute pulmonary thromboembolism. The patient had severe peripheral ischemia due to a massive thrombus and was treated successfully by peripheral thrombectomy, thrombolysis, implantation of a permanent inferior vena cava filter and anticoagulation.

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