• Internal medicine · Jan 2020

    Case Reports

    A Successful Treatment Strategy for Paradoxical Cerebral Embolism Accompanied by Entrapped Thrombus in Patent Foramen Ovale.

    • Takuto Ishida, Kazuki Miyazaki, Hiroshi Shimizu, Keita Shibahashi, Hidenori Hoda, Ryo Itagaki, Kazuhiro Sugiyama, Takahiro Tanabe, and Yuichi Hamabe.
    • Tertiary Emergency Medical Center, Tokyo Metropolitan Bokutoh Hospital, Japan.
    • Intern. Med. 2020 Jan 15; 59 (2): 211-214.

    AbstractA 73-year-old man was transferred to our hospital with dyspnea and left hemiplegia. The diagnosis of pulmonary embolism, entrapped thrombus in patent foramen ovale (PFO), and internal carotid artery occlusion was made by imaging studies. We decided to perform endovascular treatment without the administration of tissue plasminogen activator (tPA) for cerebral embolism because of concern about further embolism caused by fragmented thrombi. After endovascular treatment, he successfully underwent surgical embolectomy for entrapped thrombus in PFO. Endovascular treatment without tPA administration and subsequent surgical embolectomy seems to be a viable treatment strategy for patients with occlusion of the large cerebral artery accompanied by entrapped thrombus in PFO.

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