Paradoxical embolism: Experiences from a single center

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 reco...

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Autores principales:	Hong-Liang Zhang, Zhi-Hong Liu, Qin Luo, Yong Wang, Zhi-Hui Zhao, Chang-Ming Xiong
Formato:	article
Lenguaje:	EN
Publicado:	KeAi Communications Co., Ltd. 2017
Materias:	Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/d4ce93bb25444a7281fd899be344a386
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spelling	oai:doaj.org-article:d4ce93bb25444a7281fd899be344a3862021-12-02T13:22:19ZParadoxical embolism: Experiences from a single center2095-882X10.1016/j.cdtm.2017.02.005https://doaj.org/article/d4ce93bb25444a7281fd899be344a3862017-06-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2095882X16301074https://doaj.org/toc/2095-882XObjective: 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 10.6â17.7 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. Keywords: Paradoxical embolism, Pulmonary embolism, Deep venous thrombosis, Patent foramen ovaleHong-Liang ZhangZhi-Hong LiuQin LuoYong WangZhi-Hui ZhaoChang-Ming XiongKeAi Communications Co., Ltd.articleMedicine (General)R5-920ENChronic Diseases and Translational Medicine, Vol 3, Iss 2, Pp 123-128 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine (General) R5-920
spellingShingle	Medicine (General) R5-920 Hong-Liang Zhang Zhi-Hong Liu Qin Luo Yong Wang Zhi-Hui Zhao Chang-Ming Xiong Paradoxical embolism: Experiences from a single center
description	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 10.6â17.7 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. Keywords: Paradoxical embolism, Pulmonary embolism, Deep venous thrombosis, Patent foramen ovale
format	article
author	Hong-Liang Zhang Zhi-Hong Liu Qin Luo Yong Wang Zhi-Hui Zhao Chang-Ming Xiong
author_facet	Hong-Liang Zhang Zhi-Hong Liu Qin Luo Yong Wang Zhi-Hui Zhao Chang-Ming Xiong
author_sort	Hong-Liang Zhang
title	Paradoxical embolism: Experiences from a single center
title_short	Paradoxical embolism: Experiences from a single center
title_full	Paradoxical embolism: Experiences from a single center
title_fullStr	Paradoxical embolism: Experiences from a single center
title_full_unstemmed	Paradoxical embolism: Experiences from a single center
title_sort	paradoxical embolism: experiences from a single center
publisher	KeAi Communications Co., Ltd.
publishDate	2017
url	https://doaj.org/article/d4ce93bb25444a7281fd899be344a386
work_keys_str_mv	AT hongliangzhang paradoxicalembolismexperiencesfromasinglecenter AT zhihongliu paradoxicalembolismexperiencesfromasinglecenter AT qinluo paradoxicalembolismexperiencesfromasinglecenter AT yongwang paradoxicalembolismexperiencesfromasinglecenter AT zhihuizhao paradoxicalembolismexperiencesfromasinglecenter AT changmingxiong paradoxicalembolismexperiencesfromasinglecenter
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Paradoxical embolism: Experiences from a single center

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