Related Experiment Videos
Stroke following variceal sclerotherapy
Frank Hanisch1, T Müller, M Krivokuca
1Neurologische Klinik, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany. frank.hanisch@medizin.uni-halle.de
European Journal of Medical Research
|July 20, 2004
Summary
Variceal sclerotherapy may rarely cause paradoxical embolism, leading to stroke in patients with a patent foramen ovale (PFO). This case highlights a potential, though uncommon, risk associated with the procedure.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- Patent foramen ovale (PFO) is a known risk factor for paradoxical embolism and ischemic stroke.
- Risk factors for deep vein thrombosis (DVT) like pregnancy, immobilization, and lower limb surgery are often associated with paradoxical embolism.
Observation:
- A 54-year-old female experienced acute ischemic stroke with aphasia and hemiparesis.
- The stroke occurred three days after variceal sclerotherapy, a procedure using polydocanol.
- Diagnostic imaging confirmed a left striatal ischemic infarction, a right-to-left shunt, and a PFO. No DVT or thrombophilia was identified.
Findings:
- A probable causal link between variceal sclerotherapy and paradoxical embolism leading to stroke was suggested.
- The patient's stroke was attributed to a right-to-left shunt through a PFO, likely triggered by the sclerotherapy procedure.
Implications:
- Variceal sclerotherapy, while generally safe, may carry a rare risk of causing embolic events.
- This case underscores the importance of considering iatrogenic causes of stroke, particularly in patients with undiagnosed shunts.