Temporary IVC filtration before patent foramen ovale closure in a patient with paradoxic embolism |
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Authors: | Lewis-Carey Mary Beth Kee Stephen T Feinstein Jeffrey A |
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Affiliation: | Department of Vascular and Interventional Radiology, Stanford University Medical Center, Room H3648, 300 Pasteur Drive, Stanford, California 94305-5642, USA. mbcarey@stanford.edu |
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Abstract: | Pulmonary embolism (PE) and associated acute peripheral ischemia suggest the diagnosis of paradoxic embolism. The most common intracardiac defect associated with paradoxic emboli is a patent foramen ovale (PFO). Therapeutic options include anticoagulation, thrombolysis, inferior vena cava (IVC) filtration, and closure of the intracardiac defect. The authors discuss the diagnosis and treatment of a young female athlete who presented with massive PE complicated by a paradoxic embolus to the right subclavian artery. Systemic and catheter-directed thrombolysis, IVC filtration, and percutaneous closure of a PFO were performed in an effort to return the patient to the level of competitiveness she desired. |
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