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[Paradoxical systemic emboli. 5 case reports].

G Janvier, A Bonnet, S Winnock

    Journal Des Maladies Vasculaires
    |January 1, 1983
    PubMed
    Summary
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    Paradoxical systemic embolism occurs when venous emboli travel to the arterial circulation, often due to a right-left shunt. Angiography confirms diagnosis, and caval filters can prevent recurrent, serious emboli.

    Area of Science:

    • Cardiology
    • Vascular Surgery
    • Diagnostic Imaging

    Context:

    • Paradoxical systemic embolism is a rare but serious condition where blood clots originating in the venous system travel to the arterial circulation.
    • This phenomenon is typically caused by an abnormal right-to-left shunt within the heart or great vessels.
    • Diagnosing and managing paradoxical emboli requires a multidisciplinary approach involving various imaging modalities.

    Purpose:

    • To describe the diagnostic criteria and management strategies for paradoxical systemic embolism.
    • To highlight the role of advanced imaging in confirming the diagnosis.
    • To emphasize the importance of preventative measures against recurrent embolic events.

    Summary:

    • This study reviewed five patients with suspected or confirmed paradoxical emboli.

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  • Definitive diagnosis was established in three patients, with suspicion in two others.
  • Venous, arterial, and cardiac angiography were crucial for defining anatomical criteria and confirming the diagnosis.
  • The introduction of a caval filter was considered to prevent recurrent emboli, given the serious prognosis.

    • Impact:

    • This research underscores the utility of comprehensive angiography in diagnosing paradoxical embolism.
    • It highlights the potential benefit of caval filters in preventing life-threatening recurrent embolic events.
    • The findings contribute to a better understanding of the pathophysiology and management of this rare condition.