Paradoxical embolus: an unusual indication for upper limb amputation.
Paradoxical emboli occur when venous embolic material passes into the arterial circulation (via a right-to-left cardiac shunt). The association of paradoxical emboli and arterial ischaemia has been described previously, especially with respect to cerebral infarcts. We describe a case in which double paradoxical emboli following a long haul flight, resulted in emergency amputation of an upper limb. Amputation resulting from a paradoxical embolus has not previously been described.
Patel
S K
SK
Department of Vascular Surgery, St George's Hospital, London, UK.
Tomlinson
M
M
Anjum
A
A
Quarmby
J
J
D000337:Aerospace Medicine; D000368:Aged; D000671:Amputation, Surgical; D015901:Angiography, Digital Subtraction; D001132:Arm / Q000098:blood supply* / Q000601:surgery; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000150:complications; D006801:Humans; D008297:Male; D014195:Travel