1. Intrahepatic Cholangiocarcinoma Associated Paradoxical Peripheral Embolism and a Submassive Pulmonary Embolism.
- Author
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Zhang SL, Zhang YS, Wei F, and DeYoung L
- Subjects
- Bile Duct Neoplasms diagnostic imaging, Bile Duct Neoplasms pathology, Cholangiocarcinoma diagnostic imaging, Cholangiocarcinoma pathology, Embolism, Paradoxical diagnostic imaging, Embolism, Paradoxical drug therapy, Factor Xa Inhibitors therapeutic use, Female, Humans, Middle Aged, Pulmonary Embolism diagnostic imaging, Pulmonary Embolism drug therapy, Rivaroxaban therapeutic use, Thrombolytic Therapy, Thrombosis diagnostic imaging, Thrombosis drug therapy, Treatment Outcome, Bile Duct Neoplasms complications, Cholangiocarcinoma complications, Embolism, Paradoxical etiology, Pulmonary Embolism etiology, Thrombosis etiology
- Abstract
Paradoxical peripheral embolism and submassive pulmonary embolism (PE), secondary to cancer-associated thrombosis, are yet to be reported in the literature. Here we describe a case presenting with an acute peripheral arterial embolism. Subsequent testing revealed a PE and an intrahepatic cholangiocarcinoma as the likely risk factors for thrombus, with arterial spread likely achieved through a patent foramen ovale. The patient's symptoms almost relieved upon catheter-directed thrombus fragmentation and aspiration, catheter-directed thrombolysis, and combined anticoagulation. Embolism and major bleeding did not occur during 6 months of follow-up under systemic anticoagulation with rivaroxaban. This case documents that catheter-directed thrombolysis and anticoagulation could be likely effective and safe in the treatment and prevention of recurrence of paradoxical embolism and PE secondary to cancer-associated thrombosis., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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