The prevalence of deep venous thrombosis in patients with suspected paradoxical embolism.
OBJECTIVE
To determine the prevalence of venous thrombosis in patients with suspected paradoxical embolism.


METHODS
Observational study.


METHODS
Two hundred sixty-four patients with clinically suspected embolic events underwent contrast transesophageal echocardiographic evaluation. Forty-nine patients (24 women, 25 men) had a patent foramen ovale. Forty-one patients had acute stroke, and 8 had acute limb ischemia.


METHODS
Echocardiography laboratory of a community hospital.


METHODS
The presence of a patent foramen ovale was assessed by transesophageal contrast echocardiography. Forty-two patients had venographic evaluation of the lower-extremity venous system.


RESULTS
Venous thrombosis was clinically suspected in 6 patients and documented in 24 of the 42 patients with patent foramen ovale who underwent venographic study (57%; 95% Cl, 41% to 72%). Venous thrombosis was confined to calf or popliteal veins in 15 cases. Fifteen of 17 patients who had venographic evaluation within 7 days of the index event had thrombosis compared with 9 of 25 patients who had later evaluations (P = 0.001). More patients with venous thrombosis than without venous thrombosis had a history of previous thromboembolism (13 of 24 compared with 1 of 18 [corrected], respectively; P = 0.001).


CONCLUSIONS
When a patent foramen ovale is detected in a patient with embolism, occult leg vein thrombosis is frequently present.
Stöllberger
C
C
Krankenanstalt Rudolfstiftung, Vienna, Austria.
Slany
J
J
Schuster
I
I
Leitner
H
H
Winkler
W B
WB
Karnik
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000150:complications; D004452:Echocardiography / Q000379:methods; D004617:Embolism / Q000150:complications*; D004947:Esophagus; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007511:Ischemia / Q000150:complications; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D015995:Prevalence; D013924:Thrombophlebitis / Q000150:complications* / Q000000981:diagnostic imaging