Open AccessParadoxical embolism: Experiences from a single center
Author(s) -
Zhang HongLiang,
Liu ZhiHong,
Luo Qin,
Wang Yong,
Zhao ZhiHui,
Xiong ChangMing
Publication year - 2017
Publication title -
chronic diseases and translational medicine
Language(s) - English
Resource type - Journals
ISSN - 2589-0514
DOI - 10.1016/j.cdtm.2017.02.005
Subject(s) - medicine , embolectomy , thrombus , thrombolysis , warfarin , pulmonary embolism , surgery , thrombosis , patent foramen ovale , venous thrombosis , cardiology , atrial fibrillation , myocardial infarction , percutaneous
Objective To present our treatment experiences and the follow‐up data of patients with paradoxical embolism (PDE). Methods The clinical characteristics, management, and follow‐up data of all included patients who were diagnosed with PDE at Fuwai Hospital from January 1994 to October 2015 were recorded. Results Twelve patients were included; all had a pulmonary embolism, and 8 had deep venous thrombosis. The artery embolisms involved the cerebral artery (7 patients), renal artery (2 patients), mesentery artery (2 patients), popliteal artery (1 patient), descending aorta thrombus (1 patient), and thrombus‐straddled patent foramen ovale (PFO) (1 patient). PFO was found in 3 cases. One patient underwent thrombectomy and PFO closure; Six patients received thrombolysis; and 3 patients were implanted with a vena cava filter. Long‐term anticoagulation with warfarin was recommended for each patient. One patient died from ventricular fibrillation despite cardiopulmonary resuscitation. Eleven patients were discharged with improvements. No late mortality occurred in 8 patients with a complete follow‐up of 10.6–17.7 years. One had a recurrent deep venous thrombosis. No patient had a recurrent pulmonary or arterial embolism. Two patients changed their treatment from warfarin to aspirin; others remained on warfarin. Only 1 case had an occasional gum bleeding. Conclusions PDE treatment including thrombolysis, anticoagulation, and embolectomy should be individualized. We recommend long‐term anticoagulation therapy to prevent the recurrence of PDE, especially to those with an intracardiac communication or persistent risk factors for re‐thrombosis.