Percutaneous endovascular treatment of acute sequential systemic emboli.
A 65-year-old woman was evaluated for acute right lower-extremity ischemia secondary to embolization from atrial fibrillation and subtherapeutic anticoagulation. Her symptoms quickly evolved in a dynamic fashion to involve multiple vascular beds, including a transient ischemic attack, abdominal pain secondary to mesenteric ischemia, and contralateral lower-extremity ischemia. Synchronous emboli were treated by using mechanical and pharmacologic thrombolysis via an endovascular approach under local anesthesia. This intervention allows prompt evaluation of multiple vascular beds with good short-term outcomes and minimal morbidity.
Columbia/Weill Cornell Division of Vascular Surgery, New York-Presbyterian Hospital, New York, NY 10032, USA.
Mark J
MJ
Russo
Rabih A
RA
Chaer
Stephanie C
SC
Lin
K Craig
KC
Kent
James F
JF
McKinsey
D015746:Abdominal Pain / Q000209:etiology; D000368:Aged; D000800:Angioplasty, Balloon; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy; D003131:Combined Modality Therapy; D004617:Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D002546:Ischemic Attack, Transient / Q000209:etiology; D035002:Lower Extremity / Q000098:blood supply*; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011859:Radiography; D017131:Thrombectomy; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator