title: Catastrophic paradoxical embolus after hemodialysis access thrombectomy in a patient with a patent foramen ovale.
abstract: We present the first case of documented clot in-transit through a patent foramen ovale (PFO), caused by mechanical thrombectomy of a clotted AV fistula. Embolus after access thrombectomy is a rare, but known complication of the procedure. Paradoxical embolus is likewise a rare consequence of a right-sided clot, embolising to the left-sided circulation in a patient with a PFO. Suspected embolus through a PFO after dialysis access thrombectomy has been reported, but no case has ever documented the clot in-transit through the PFO.
authors.affiliation: Obstetrics and Gynecology, Baylor University Medical Center, 621 N. Hall St Suite 500, Dallas, TX 75226, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Pinard
authors.forename: Samina
authors.initials: S
authors.lastname: Fazal
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Schussler
mesh_terms: D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D004452:Echocardiography / Q000379:methods; D019320:Embolism, Paradoxical / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D035583:Rare Diseases; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D018570:Risk Assessment; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D062666:Vascular Access Devices / Q000009:adverse effects