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在大规模肺栓塞患者的导管血栓抑制剂期间发生矛盾的栓塞性中风:一个病例报告
Atefeh Ghorbanzadeh1, Emily C Bendel2, Damon E Houghton1
1Department of Cardiovascular Diseases, Division of Vascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Brain circulation
|April 14, 2025
概括
这一案例突出了一个罕见的大量肺栓塞 (PE) 病例,在治疗期间因中风而复杂. 它强调了大规模PE的诊断挑战和复杂的管理.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 血管医学 血管医学
背景情况:
- 悖论性栓塞是肺栓塞 (PE) 的一个关键并发症.
- 大规模的PE带来了重大风险,包括栓塞性中风.
- 在巨大的PE中确定栓塞的来源可能是具有挑战性的.
研究的目的:
- 在治疗期间报告一次大规模PE病例与同时发生的栓塞性中风.
- 讨论与此类病例相关的诊断困难和治疗复杂性.
- 在没有典型的血栓瘤发现的情况下,探索矛盾栓塞的潜在来源.
主要方法:
- 病例报告详细介绍了一名患有大量PE和栓塞性中风的患者.
- 诊断工作包括下肢多普勒超声波,腹部CT扫描和胸前心电回声.
- 对大规模PE进行了导管导向的血栓溶解疗法.
主要成果:
- 介绍了一例在血栓解压疗法期间因栓塞性中风而复杂的大量PE病例.
- 最初的评估没有显示出下肢或腹部血栓形成的证据.
- 考虑了栓塞的潜在来源,包括左心房附属体血栓,肺动脉静脉形形和圆孔.
结论:
- 大规模的PE可以出现复杂和危及生命的并发症,如栓塞性中风.
- 在确定栓塞源方面存在诊断挑战,特别是在没有明显的血栓形成的情况下.
- 有效的管理需要对悖论性栓塞及其潜在来源有充分的了解.
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