Shut that door: a man with contemporaneous multisite paradoxical embolization
Related Experiment Video
Updated: Jun 24, 2026
Combination of High Ligation and Intraoperative Embolization Using Polidocanol for Treatment of Varicoceles
Published on: December 22, 2023
Gianluca Rigatelli1, Fabio Dell'Avvocata, Paolo Cardaioli
1Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. jackyheart@hotmail.com
Abstract:
Patent foramen ovale (PFO) has been recognized as mediator of paradoxical embolism. Concurrent multisite paradoxical embolization is a quite rarely reported occurrence. We present a case of multisite paradoxical embolism (pulmonary, cerebral, upper limb) mediated by a large right-to-left shunt mediated by a PFO with associated a redundant Eustachian valve, successfully treated with PFO transcatheter closure and vena cava filter placement.
Insights
Patent foramen ovale (PFO) can cause paradoxical embolism. This rare case details successful treatment of multisite paradoxical embolization via PFO closure and filter placement.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Patent foramen ovale (PFO) is a known cause of paradoxical embolism.
- Multisite paradoxical embolization is an uncommon clinical presentation.
Observation:
- A patient presented with concurrent pulmonary, cerebral, and upper limb emboli.
- A large right-to-left shunt through a PFO with a redundant Eustachian valve was identified as the cause.
Findings:
- Transcatheter closure of the PFO was performed.
- A vena cava filter was placed to prevent further embolization.
Implications:
- This case highlights the potential for PFO to cause extensive paradoxical embolization.
- Successful transcatheter PFO closure and filter placement offer a viable treatment strategy for complex paradoxical embolism.
