Aorto-subclavian thromboembolism: a rare complication associated with moderate ovarian hyperstimulation syndrome.
The case of an arterial aorto-subclavian thromboembolism associated with a moderate ovarian hyperstimulation syndrome (OHSS) and following ovulation induction for in-vitro fertilization in a young woman is reported. Because of the lack of response to systemic thrombolysis, a left postero-lateral thoracotomy was performed on day 8 after embryo transfer. A fibrinocruoric embolus situated at the junction of the left subclavian artery from the aorta was removed through a left subclavian arteriotomy. The distal axillary embolus was removed by a retrograde balloon catheter embolectomy. A moderate OHSS was observed. The ovarian stimulation and OHSS-related risks of thromboembolism are discussed. We conclude that, in the absence of risk factors, counselling about possible complications resulting from stimulation must be emphasized.
Germond
M
M
Fertility Unit, Department of Gynaecology and Obstetrics, Service of Anesthesiology, Service of Cardiovascular Surgery and Department of Radiology, CHUV, 1011 Lausanne, Switzerland.
Wirthner
D
D
Thorin
D
D
Ruchat
P
P
Essinger
A
A
De Grandi
P
P
D000328:Adult; D001011:Aorta; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008596:Menotropins / Q000627:therapeutic use; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications*; D010062:Ovulation Induction / Q000009:adverse effects* / Q000379:methods; D013348:Subclavian Artery; D013923:Thromboembolism / Q000209:etiology*; D017329:Triptorelin Pamoate / Q000627:therapeutic use
D006063:Chorionic Gonadotropin; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins