• Guang Huang, Yu Tang, Hailiang Wang, Rong Xiong, and Ainan Xu.
• Neurology Department of Fu Xing Hospital affiliated to Capital Medical University, Beijing, China.
• Medicine (Baltimore). 2019 Jul 1; 98 (30): e16522.

IntroductionParadoxical embolism (PDE) refers to direct passage of venous thrombi into the arterial circulation through an arteriovenous shunt. It is well-known that the pulmonary thromboembolism (PTE) can cause opening of the foramen ovale leading to paradoxical arterial embolism. Long term follow up of PDE patient over 10 years was not reported in the literature.Patient ConcernsA 57-year-old woman presented with initial symptoms of numbness/weakness and hypoxemia. Ultrasonography and pulmonary arteriography indicated pulmonary thromboembolism.DiagnosisPulmonary embolism and paradoxical multiple arterial embolism or acute PTE concomitant with paradoxical multiple arterial embolism.InterventionsCraniectomy and anticoagulation treatment was administered and the patient received low-dose warfarin therapy for 10 years.OutcomesThe patient is currently stable with no abnormalities seen in the deep veins of the bilateral lower limbs. The international normalized ratio (INR) was controlled within the range of 1.20 to 1.51. As this is a 10-year follow-up case report, the patient has responded well to the treatment and has been followed-up. The follow-up has been annual and the patient has been stable CONCLUSION:: Low intensity and persistent anticoagulation therapy can inhibit blood thrombophilia and reduce the risk of bleeding. It is noteworthy that such an approach used effectively in this patient. To best our knowledge, it is first report for long term follow up PDE patient successfully over 10 years.

22 keywords...

hide…