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World Journal of Gastroenterology 2008年第22期14卷 3563-3568页

作者： Hong-Yan Cheng Xiao-Yan Wang Guo-Li Zhao Dong Chen Department of Radiology Eastern Hepatobiliary Surgery Hospital 225 Changhai Road Shanghai 200438 China

AIM: To analyze the imaging findings of hepatic malignancy with right atrial (RA) embolus. METHODS: Forty-six patients with an embolus in the RA were diagnosed, including 44 patients with hepatocellular carcinoma (HCC), 1 patient with cholangiocellular carcinoma and 1 patient with hepatic carcinoma metastasis. The diagnosis was confirmed by clinical examination, serum α-fetoprotein and imaging. Seventeen patients underwent transcatheter arterial chemoembolization (TACE). RESULTS: On enhancement computer tomography (CT) or magnetic resonance (MR) imaging, a nodular filling defect in the RA could be easily found, with a slight enhancement in the arterial phase. The coronal images of CT or MR showed the extent of lesion. Lipiodol entered the embolus after TACE, hence reducing the speed of embolus growth. There was a survival benefit for patients receiving anticancer treatment. CONCLUSION: Patients with HCC, showing a filling defect of the inferior vena cava (IVC), hepatic vein (HV) and RA on images, can be diagnosed with RA embolus. Encroachment of the RA is very rare in patients with hepatic malignancies. Furthermore, a prolongation of survival time is found in those patients who underwent TACE.

关键词： Carcinoma Liver Neoplasm Metastasis embolus Right atrium Computed tomography X-Ray Magnetic resonance

Paradoxical embolus straddling patent foramen ovale demonstrated by computed tomographic pulmonary angiography

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World Journal of Clinical Cases 2013年第3期1卷 108-110页

作者： Laura Cormack John T Murchison Department of Radiology Edinburgh Royal InfirmaryEdinburgh EH16 4SAUnited Kingdom

An elderly gentleman presented to the emergency department with a recent history of dyspnoea, collapse and transient neurological symptoms. He was noted to be hypoxic with a significantly elevated D Dimer. A computer tomography pulmonary angiogram demonstrated a large embolus with a further filling defects within the left and the right atria, abutting the interatrial septum. Suspicion of a paradoxical pulmonary embolus was raised and the patient subsequently underwent echocardiography which confirmed a patent foramen ovale(PFO). He was commenced on warfarin therapy. In patients with elevated right heart pressure, a PFO can be unmasked and give rise to cerebral emboli. Clinical suspicion should be raised in patients with pulmonary emboli or deep venous thrombosis if there is a concomitant history of focal neurological symptoms.

关键词： Pulmonary embolus Paradoxical embolus Computer tomography pulmonary angiogram Patent foramen ovale Stroke

Management of a patient with perioperative saddle embolus

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World Journal of Anesthesiology 2013年第1期2卷 11-13页

作者： Austin Lee Jaime Ortiz Department of Anesthesiology Baylor College of Medicine Houston TX 77030 United States

Pulmonary embolism is a major cause of morbidity and mortality. Risk factors include venous stasis, endothelial injury, and hypercoagulability. Prevention centers on the use of sequential compression devices and anticoagulation in the hospital patient. This is the case of a 45-year-old male who presented for open reduction and internal fixation of tibia plateau fracture. He developed a saddle embolus during the perioperative period which was diagnosed in the recovery room after workup for the cause of his poor oxygenation. A chest computed tomographic scan showed an extensive saddle embolus with partial occlusion of the bilateral main pulmonary arteries and all segmental pulmonary artery branches. This case report discusses his diagnosis, management and clinical course. In addition, risk factors, treatment and prevention for pulmonary embolus and described.

关键词： Venous thromboembolism Pulmonary embolus Saddle embolus Tibia fracture Anesthesia

Different effects of mechanical embolus removal and intra-arterial thrombolysis on neural functional recovery in patients with acute middle cerebral artery occlusion

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Journal of Hainan Medical University 2018年第16期24卷 30-33页

作者： Guo-Wei Wang Ya-Fei Wang Long-Wei Huo Bo Ma Zheng Cui Xuan-Yu Zhang Jiang-Feng Li Hu-Lin Zheng Neurosurgery Department No.2 Ward the First Hospital of Yulin Shaanxi ProvinceYulinShaanxi Province719000

Objective:To study the different effects of mechanical embolus removal and intra-arterial thrombolysis on neural functional recovery in patients with acute middle cerebral artery ***: Patients with acute middle cerebral artery occlusion who were treated in the First Hospital of Yulin between September 2013 and October 2017 were selected and retrospectively studied, and the differences in reperfusion therapies in history data were referred to divide them into study group A and study group B who underwent mechanical embolus removal and intra-arterial thrombolysis respectively. The levels of neurocyte damage markers, apoptosis markers and stress markers in serum as well as the expression of Wnt pathway molecules in peripheral blood were determined before treatment and 24 h after ***: Compared with those of same group before treatment, serum NSE, S100B, VILIP1, sFas, sFasL, ET-1 and MDA levels as well as peripheral blood GSK3β, LC3-II and Beclin1 expression intensity of both groups were decreasing whereas serum BDNF, NTF, sLivin and SOD levels as well as peripheral bloodβ-catenin and mTOR expression intensity were increasing, and serum NSE, S100B, VILIP1, sFas, sFasL, ET-1 and MDA levels as well as peripheral blood GSK3β, LC3-II and Beclin1 expression intensity of study group A after treatment were lower than those of study group B whereas serum BDNF, NTF, sLivin and SOD levels as well as peripheral bloodβ-catenin and mTOR expression intensity were higher than those of study group ***: Mechanical embolus removal for acute middle cerebral artery occlusion can be more effective than intra-arterial thrombolysis to reduce the nerve function damage as well as the corresponding oxidative stress and apoptosis.

关键词： Acute middle cerebral artery occlusion Mechanical embolus removal Intra-arterial thrombolysis Oxidative stress Apoptosis

Intracranial hemorrhagic embolus

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Journal of Acute Disease 2017年第1期6卷 45-46页

作者： Yu-Hang Yeh Yu-Jang Su Department of Emergency Medicine Taipei City HospitalZhongxing BranchTaipeiTaiwan Department of Emergency Medicine Mackay Memorial HospitalNo.92Sec 2Chung-Shan North RdTaipei 10449Taiwan Department of Oral Hygiene College of Oral MedicineTaipei Medical UniversityTaipeiTaiwan Department of Medicine Mackay Medical CollegeNew Taipei CityTaiwan Mackay Junior College of Medicine Nursing and ManagementTaipeiTaiwan

A febrile and unconscious man was sent to our emergency department. On physical examinations, some dark red ecchymosis/discoloration over the trunk and track mark in the left-sided groin region were seen. Brain CT scan showed septic emboli complicated with hemorrhage. Chest X-ray revealed pulmonary emboli. Aortic valve vegetation was found by echocardiography. Although aggressive treatment and resuscitation were taken, he died of methicillin-sensitiveStaphylococcus aureus sepsis and multiple organ failure. Intravenous drug users are susceptible to right-sided infective endocarditis. In our case, left-sided infective endocarditis with lung and brain embolism resulting in fatality was relatively uncommon. Review of literature was also made for this article.

关键词： Infective endocarditis Septic embolus Methicillin sensitive Staphylococcus aureus Aortic valve Intravenous drug user

A New Model of Experimental Cerebral Infarction in New Zealand White Rabbits

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Journal of Huazhong University of Science and Technology(Medical Sciences) 1995年第1期15卷 5-9页

作者：张苏明 Department of Neurology Tongji Hospital of Tongji Medical University Wuhan St. Paul-Ramsey Medical Center and University of Minnesota St. Paul USA Department of Neurosurgery University of Minnesota Minneapolis USA

To develop an easy, reproducible experimental model of cerebral infarction(CI)without craniotomy in New Zealand white rabbits,a silicone rubber cylinder embedded in a nylon suture was delivered to the middle cerebral arteries through the internal carotid artery in anesthetized *** were sacrificed 0.5-5 h after *** size and location were ascertained by the tripheny1-2H-tetrazoliuni chloride(TTC)staining method;cerebral blood flow(CBF)was measured prior to and after ***2,temperature and blood pressure were monitored and kept *** occurred in all rabbits after 4 h of ischemia,in 50% after 3 h and only in 33% after 2.5 *** did not occur within less than 2.5 h of *** correlation was found between size and location of CI and occlusion *** was maximally reduced in the right MCA territory but was also reduced in both anterior cerebral arteries and left MCA *** model is technically easy and the retrievable embolus allows the study of reperfusion by pulling on the nylon *** is suitable for studying chemical and molecular changes of the ischemic cells and/or for studying neuroimage changes after ischemic stroke.

关键词： experimental cerebral infarction rabbit animal model embolus reperfusion CBF

Endovascular Treatment Options of Acute Limb Ischemia

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2013年第1期2卷 39-43页

作者： Di Zhang Wensheng Lou Guoping Chen Xindao Yin Jianping Gu Department of Radiation Physics Nanjing Hospital Nanjing Medical University Nanjing China

Acute limb ischemia is a urgent condition which occurs when there is an abrupt interruption of blood flow into an extremity usually because of either embolic or thrombotic vascular occlusion. Restoration of perfusion through early intervention can decrease amputation and mortality. Contemporary treatment includes both surgery and endovascular techniques. There is a rapid progress in endovascular intervention therapy. This article aims to make a comprehensive review of the endovascular intervention options of acute limb ischemia.

关键词： Acute Limb Ischemia Arterial embolus Arterial Thrombosis Endovascular Therapy

Systemic air embolism after transthoracic lung biopsy: A case report and review of literature

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World Journal of Radiology 2010年第5期2卷 193-196页

作者： Wessam Bou-Assaly Perry Pernicano Ellen Hoeffner Department of Radiology Neuroradiology Division University of Michigan Health System Ann Arbor VA Health system A. Alfred Taubman Health Care Center 1500 East Medical Center Drive Department of Radiology University Hospital 1500 East Medical Center Drive

Computed tomography (CT)-guided lung biopsy is a common diagnostic procedure that is associated with various complications, including pneumothorax, hemoptysis and parenchymal hemorrhage. Systemic air embolism is a very rare (0.07%) but potentially lifethreatening complication. We report a fatal case of air embolism to the cerebral and coronary arteries confirmed by head and chest CT, followed by a review of the literature.

关键词： Systemic air embolism Transthoracic lung biopsy Air embolus Lung mass Needle biopsy Stroke Complications