ABSTRACT
Key Clinical Message: Percutaneous precutaneous mechanical thrombectomy has been used for clot dissolution and removal in selected cases of iliofemoral deep vein thrombosis. Intravascular Hemolysis and hemoglobinuria caused by pharmachomechanical chather directed thrombolysis (PCDT) devices like the Angiojet is associated with an increased risk of acute kidney injury (AKI). Acute tubular necrosis that is severe enough to require hemodialysis can occur. Clinicians should be aware of this potential risk to ensure early recognition and timely referral to the nephrologist, and a clear explanation of the risk of AKI should be given to the patients undergoing this procedure. Abstract: Lower extremity deep vein thrombosis (DVT) is a frequently encountered medical condition, and one that can lead to death or major disability if not promptly treated. Anticoagulation alone may not always be enough for complete treatment. It has been reported that early thrombus removal can rapidly relieve symptoms and prevent disease progression in some selected cases. Percutaneous pharmacomechanical thrombectomy has been used for clot dissolution and removal in such cases. AngioJet is an increasingly used method of percutaneous mechanical thrombectomy for DVT that can cause intravascular hemolysis and potentially acute kidney injury (AKI). We report here a case of a 39 years old lady who developed severe AKI (illustrated by creatinine level of 664 µmol/L (7.5 mg/dL), bicarb of 13 mmol/L and being anuric), requiring hemodialysis secondary to intravascular hemolysis and hemoglobinuria that occurred immediately after the use of AngioJet pharmacomechanical catheter-directed technique to treat an extensive iliofemoral DVT.
ABSTRACT
The artery of Percheron (AOP), a variation of the thalamic vasculature, supplies both the thalamus and the midbrain. An infarct in this area is characterized by wide neurological abnormalities, the most common of which are altered mental state, decreased degree of consciousness, and memory impairment. AOP infarcts tend to be missed during the initial computed tomography (CT) scan. The number of reports on AOP infarction has been increasing, highlighting the range of clinical presentations and challenges that clinicians can face. This case study discusses a 58-year-old male patient who was diagnosed with stroke in AOP territory without any clear neurological symptoms, and it serves as a model for patients with similar conditions.
ABSTRACT
Multiple primary malignancies are a well-recognized entity, with increased recognition and detection alongside development of hybrid imagining. We present a rare case of a 16-year-old male with gnathic osteosarcoma and incidental finding of a second silent synchronous B-cell lymphoblastic lymphoma/leukemia in the lower limb. Treated successfully by chemotherapy, radiotherapy, and surgery.
ABSTRACT
Pulmonary tuberculosis is a common endemic disease in developing countries but its thrombogenic tendency is not well-studied and established yet. Pulmonary embolism is rarely reported in Mycobacterium tuberculosis infection. There are reports stating the relation of pulmonary embolism (PE) and deep vein thrombosis (DVT) with a severe infection of tuberculosis but no data is available to establish a mutual association between pulmonary tuberculosis and pulmonary thromboembolism. Herein, we report the case of a 51-year-old male who presented with a one-month history of productive cough, shortness of breath, and fever associated with chills and night sweating. He reported an 8 kg weight loss in the last month. He was found to have pulmonary tuberculosis. On further investigations for leg swelling and tachycardia. Deep vein thrombosis and sub-massive saddle bilateral pulmonary embolism were diagnosed, which was treated with thrombolysis therapy (alteplase). He responded well to initial therapy and was discharged on anticoagulation with anti-tuberculous therapy (ATT).