Idiopathischer flottierender linksventrikulärer Thrombus
Autor: | Knapp E, Wohlfarter T, Schwaighofer H, H.-J. Lisch, T. Hopferwieser, Herbert Braunsteiner, Kunz F, Monika Lechleitner |
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Rok vydání: | 2008 |
Předmět: |
medicine.medical_specialty
business.industry Adductor canal Streptokinase medicine.medical_treatment Embolectomy General Medicine Femoral artery Left ventricular thrombus medicine.disease Surgery medicine.anatomical_structure Embolus medicine.artery cardiovascular system medicine cardiovascular diseases Thrombus Vein business medicine.drug |
Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 116:808-811 |
ISSN: | 1439-4413 0012-0472 |
Popis: | Four weeks after appendicectomy a 28-year-old man developed dragging pains in the left calf. Left popliteal, posterior tibial and dorsalis pedis arteries could not be palpated. Angiography revealed an embolic occlusion of the left superior femoral artery at the level of the adductor canal. Echocardiography demonstrated a pedunculated left ventricular thrombus, 3.5 x 2.0 cm, as a possible source of the embolus. After successful trifurcation embolectomy and saphenous vein patch-plasty acenocoumarol, 4 mg/d and heparin, 3 x 7500 IU/d were administered. Because the thrombus failed to shrink, systemic thrombolysis, initially 750,000 IU streptokinase and 3000 IU heparin i.v., was begun. After five days the thrombus diameter had decreased to 0.7 cm. But because thrombus movement had increased, streptokinase was replaced by 70 IU/d ancrod i.v. The thrombus completely disappeared within two weeks. The patient was symptom-free during the period of anticoagulation with acenocoumarol. Six months later echocardiography confirmed the absence of thrombus in the left ventricle. |
Databáze: | OpenAIRE |
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