The successful surgical treatment of a paradoxical embolus to the carotid bifurcation.
McKinney, William B. MD a; O'Hara, Walter MD a; Sreeram, Kam MD a; Hudson, John A. MD b; Solis, Maurice MD a
[Report] Journal of Vascular Surgery. 33(4):880-882, April 2001.

(Format: HTML, PDF)

Paradoxical embolism is a rare cause of ischemic stroke. We report the case of a 67-year-old man who had a saddle embolus to the carotid bifurcation successfully treated with emergency embolectomy. Transesophageal echocardiogram revealed a large patent foramen ovale and an easily demonstrable right-to-left shunt. Subsequent investigations revealed proximal deep venous thrombosis in the left femoral and popliteal veins and multiple pulmonary emboli. Long-term anticoagulation was instituted for the diagnosis of paradoxical embolism. The patient's recovery was uneventful, and he remained neurologically intact. A literature review emphasizes the role of transesophageal echocardiography and suggests that paradoxical embolism may be a more common cause of stroke than previously thought. (J Vasc Surg 2001;33:880-2.)

Copyright (C) by the Society for Vascular Surgery, and the North American Chapter, International Society for Cardiovascular Surgery