Prevention of Paradoxical Cerebral Embolus with Protection System during Combination Right Atrial Clot Aspiration Thrombectomy and Closure of Patent Foramen Ovale

Jason Chiang; Sipan Mathevosian; Jamil Aboulhosn; John M Moriarty

doi:10.1055/s-0041-1730117

The Arab Journal of Interventional Radiology, Table of Contents

CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2021; 5(01): 052-055
DOI: 10.1055/s-0041-1730117

Case Report

Prevention of Paradoxical Cerebral Embolus with Protection System during Combination Right Atrial Clot Aspiration Thrombectomy and Closure of Patent Foramen Ovale

Jason Chiang

¹Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States

,

Sipan Mathevosian

¹Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States

,

Jamil Aboulhosn

²Division of Cardiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States

,

John M Moriarty

¹Department of Radiology, Ronald Reagan UCLA Medical Center, Los Angeles, California, United States

› Author Affiliations

Abstract

In this technical case report, we describe a 41-year-old female with a history of breast cancer who was found to have a right atrial clot attached to the tip of her Port-A-Cath. During transthoracic echocardiography to evaluate her clot, she was also noted to also have a patent foramen ovale. The decision was made to perform a simultaneous right atrial endovascular aspiration thrombectomy and patent foramen ovale closure. To minimize the risk for paradoxical embolus during clot manipulation, an intravascular embolic neuroprotection device was deployed. After the procedure, it was noted on visual inspection that the device filter contained several embolic fragments. The presence of macroscopic embolic fragments in the filter baskets highlights the role of prophylactic embolic protection when performing cardiac interventions in the setting of a patent foramen ovale, particularly in the presence of a right atrial thrombus or mass.

Keywords

thrombectomy - neuroprotection - patent foramen ovale

Full Text

References

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