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Case Report
Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters
1 Department of Vascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
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Mingjin Guo
Department of Vascular Surgery, Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Rd., Qingdao, Shandong 266000,
China
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Article ID: 101010Z01JY2019
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How to cite this article
Yan J, Wu J, Liu B, Jiao X, Li W, Guo M. Catheter-directed thrombolysis for thrombi in right atrium and upper extremity caused by peripherally inserted central catheters. Int J Case Rep Images 2019;10:101010Z01JY2019.ABSTRACT
Introduction: Peripherally inserted central catheters (PICC) are widely applied in clinical practice. One of the foremost complications is the potential risk for thrombosis associated with their use. Especially the thrombi within the cardiac chambers are rarely observed in clinical practice, but they are potentially deadly to patients for pulmonary embolism. There are no evidencebased guidelines for their treatment, and the optimal treatment is controversial (conservative or positive).
Case Report: We report the case of a 52-year-old female, who presented with both a right atrial thrombus and upper extremity deep vein thrombi on three days following PICC insertion. After an elaborate surgery with two catheters for thrombolysis and one filter for prevention of pulmonary embolism, the thrombi were dissolved effectively without occurrence of any complications.
Conclusion: In summary, regarding the treatment choice of complex thrombi in both right atrium and upper extremity, with the development of vascular surgery and interventional equipment, interventional treatment might be a well-tolerated therapeutic option. The ingenious surgical design of two catheters for thrombolysis and one filter for prevention of pulmonary embolism highlights a safe and feasible treatment for this kind of thrombi with minimal trauma.
Keywords: Catheter-directed thrombolysis, Peripherally inserted central catheters, Right atrium, Thrombi
SUPPORTING INFORMATION
Author Contributions
Junwei Yan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jiang Wu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bing Liu - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Xuefei Jiao - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Wei Li - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Mingjin Guo - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Junwei Yan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
