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Fatal paradoxic embolism occurring during IVC filter insertion in a patient with chronic pulmonary thromboembolic
T B Kinney1, S C Rose, G W Lim
1Department of Radiology, University of California San Diego Medical Center, 200 W. Arbor Dr., San Diego, California 92103-8756, USA. tbkinney@ucsd.edu
Abstract:
A patient diagnosed with chronic thromboembolic disease experienced a fatal intraprocedural paradoxic embolism during inferior vena cava (IVC) filter insertion. The frequency of patent intra-atrial shunts in patients with chronic thromboembolic disease is surprisingly high, occurring in approximately 29.5% of patients with chronic thromboembolic disease. Prevention of embolic events during venous interventions in such cases requires that the operator recognize that central shunts may be present and strictly adhere to meticulous technique during IVC filter insertion.