title: The prevalence of deep venous thrombosis in patients with suspected paradoxical embolism.
abstract: 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.
authors.affiliation: Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Stöllberger
authors.forename: J
authors.initials: J
authors.lastname: Slany
authors.forename: I
authors.initials: I
authors.lastname: Schuster
authors.forename: H
authors.initials: H
authors.lastname: Leitner
authors.forename: W B
authors.initials: WB
authors.lastname: Winkler
authors.forename: R
authors.initials: R
authors.lastname: Karnik
mesh_terms: 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