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Pulmonary Embolism I: Introduction01:19

Pulmonary Embolism I: Introduction

A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...

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Related Experiment Video

Updated: May 7, 2026

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Mobile Thrombus Observed Around an Impella Device.

Toru Miyoshi1, Takashi Nishimura2, Yu Hiasa1

  • 1Department of Cardiology, Pulmonology, Hypertension, and Nephrology, Ehime University Graduate School of Medicine, Toon, JPN.

Cureus
|October 30, 2024
PubMed
Summary

Impella devices can support patients with cardiogenic shock, but long-term use may cause thrombus. Careful monitoring during Impella removal is crucial to detect and manage potential blood clots.

Keywords:
ascending aorta thrombosiscardiogenic shockimpellaleft ventricular assist device (lvad)transesophageal echocardiography

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Area of Science:

  • Cardiology
  • Medical Devices
  • Vascular Surgery

Background:

  • The Impella device is a percutaneous ventricular assist device used for patients experiencing cardiogenic shock.
  • While effective, some patients may require prolonged support, leading to Impella dependence.
  • Long-term use of ventricular assist devices carries a risk of thrombus formation.

Observation:

  • A case study involving a young male patient with acute myocardial infarction requiring Impella 5.5 support is presented.
  • Initially, no thrombus was detected in the ascending aorta during Impella support.
  • Following Impella device removal, a mobile thrombus was identified.

Findings:

  • Computed tomography imaging the day after Impella removal revealed thrombosis in the iliac artery.
  • This case highlights the potential for delayed thrombus detection after Impella device explantation.
  • The mobile thrombus observed post-removal suggests a risk of systemic embolism.

Implications:

  • Diligent and thorough monitoring is imperative during and after Impella device removal.
  • Early detection and management of thrombus are critical to prevent complications in patients supported by Impella devices.
  • This case underscores the importance of vigilance for vascular complications associated with ventricular assist device therapy.