Vanishing Thrombus Resulting in Pulmonary Saddle Embolism

Oriowo Babatunde

doi:10.4172/2329-6925.1000169

Abstract

While there are rare reports of pulmonary embolism in patients with acute deep venous thrombosis following duplex venous scanning, it is distinctly rare to document a case of pulmonary embolism during the scan. This case demonstrates the challenge for the technologist and reading physician as well as possible preventive measures to be utilized during scanning in patients with acute deep venous thrombosis.

Highlights

The precise number of people affected by acute Deep Venous Thrombosis (DVT) and /Pulmonary Embolism (PE) is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States [1]
We report the case of a 53 year old gentleman with a middle cerebral artery distribution stroke with hemorrhagic conversion and cerebral edema and status post craniectomy and residual spastic right hemiparesis CVA
There are reports of free floating thrombi and thrombi developing after intervention resulting in pulmonary embolism, but a true vanishing thrombus, by definition is one that disappears by the time of completion of a standard lower extremity venous Doppler exam, is a rare entity [5]

Summary

Introduction

The precise number of people affected by acute Deep Venous Thrombosis (DVT) and /Pulmonary Embolism (PE) is unknown, but estimates range from 300,000 to 600,000 (1 to 2 per 1,000, and in those over 80 years of age, as high as 1 in 100) each year in the United States [1]. Most thrombi detected by DVS are fairly well attached to the vein wall and stable. There are reports in the literature of ‘free floating’ thrombi that later propagate and cause pulmonary embolism [3,4]. Even with this entity, since DVS is not three dimensional, the label of ‘free floating’ is somewhat controversial. There are few published reports of a well visualized deep vein thrombus on DVS, which ‘vanished’ either during the same examination or soon thereafter followed by a documented pulmonary embolus

Case History

Discussion