Concomitant AngioVac thrombectomy and patent foramen ovale closure in a patient with a large right atrial thrombus and recent paradoxical embolic stroke
- 5 March 2021
- journal article
- research article
- Published by Galenos Yayinevi in Diagnostic and Interventional Radiology
- Vol. 27 (2), 272-274
- https://doi.org/10.5152/dir.2021.20291
Abstract
A 59-year-old male with a history of gallbladder adenocarcinoma receiving chemotherapy and on therapeutic anticoagulation for portal vein thrombosis presented to the emergency department via ambulance after being found unresponsive and in cardiac arrest. Initial workup upon return of spontaneous circulation revealed a large right atrial mass, patent foramen ovale (PFO), and bilateral acute cortical infarctions. This constellation of findings were concerning for PFO-related paradoxical embolic strokes. Given the risk of recurrent paradoxical embolic events and the absolute contraindication to thrombolysis due to recent cerebral infarction, the decision was made to proceed with percutaneous vacuum-assisted thrombectomy using the AngioVac device. To prevent intraoperative thrombus propagation, PFO-closure was performed immediately prior to thrombectomy. Aspiration thrombectomy and PFO-closure were successful with complete thrombus removal and no intraoperative thrombus propagation. This case presents a minimally invasive and rapid treatment for a complex problem. An efficient and effective interdisciplinary team-based approach allowed the patient to resume cancer treatment relatively unabated.Keywords
This publication has 8 references indexed in Scilit:
- Percutaneous Vacuum-Assisted Thrombectomy Using AngioVac Aspiration SystemCardiovascular Revascularization Medicine, 2019
- Management of Patients with Patent Foramen Ovale and Cryptogenic Stroke: An UpdateCardiology, 2019
- Successful cerebral protection during removal of large right atrial thrombus with AngioVac in a patient with patent foramen ovale and recent embolic strokeJournal of Vascular Surgery Cases, Innovations and Techniques, 2019
- AngioVac for extraction of venous thromboses and endocardial vegetations: A meta‐analysisJournal of Cardiac Surgery, 2019
- Patent Foramen Ovale Closure for Stroke Prevention and Other DisordersJournal of the American Heart Association, 2018
- Comparative efficacy of different modalities for treatment of right heart thrombi in transit: A pooled analysisVascular Medicine, 2015
- A Novel Technique for Endovascular Removal of Large Volume Right Atrial Tumor ThrombusCardioVascular and Interventional Radiology, 2014
- Catheter extraction of high risk right atrial clot, technical tips, and lessons learned. successes and failuresCatheterization and Cardiovascular Interventions, 2013