Abstract
A-76-year-old woman consulted for open biopsy for a pulmonary mass. Thoracoscopic wedge resection was performed. The lesion was histologically diagnosed as nonspecific inflammation. On the first postoperative day (POD1), the patient lost consciousness transiently. Eleven hours after the first stroke, the patient experienced a second stroke together with hypoxia. Pulmonary perfusion scan on POD2 showed multiple perfusion defects, and the patient was diagnosed with pulmonary embolism (PE). Thrombolitic therapy was started. Neurological symptoms didn’t improve, and cerebral angiography on POD3 showed delayed perfusion in superficial veins. The patient was diagnosed with cerebral venous thrombosis (CVT). Thrombolytic and anticoagulant therapy had been continued, and the patient was found to have hemorrhagic cerebral infarction on POD11. After persistent therapy, the patient was discharged on POD120. Although both PE and CVT are rare complications after thoracic surgery, we must consider these complications in patients undergoing thoracic operations including thoracoscopic surgery.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ziomek S, Read RC, Tobler HG, Harrell JE, Gocio JC, Fink LM, et al. Thromboembolism in patients undergoing thoracotomy. Ann Thorac Surg 1993;56:223–227.
Ferro JM, Canhao P, Stam J, Bousser MG, Barinagarrementeria F. Prognosis of cerebral vein and dural sinus thrombosis: results of international study on cerebral vein and dural sinus thrombosis. Stroke 2004;35:664–670.
Cakmak S, Mighoghossian N, Desestret V, Hermier M, Cartalat-Carel S, Derex L, et al. Pulmonary embolism: an unusual complication of cerebral venous thrombosis. Neurology 2005;65:1136–1137.
Kameyama K, Huang CL, Liu D, Okamoto T, Hayashi R, Yamamoto Y, et al. Pulmonary embolism after lung resection: diagnosis and treatment. Ann Thorac Surg 2003;76:599–601.
Morikawa H, Okubo K, Kobayashi M, Hayatsu E, Isobe J, Ueno Y. A case of thromboembolism after operation for spontaneous pneumothorax in a juvenile patient. Nihon Kokyukigeka Gakkaizasshi (Jpn J Chest Surg) 2005;19:701–704 (in Japanese with English abstract).
Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell CW, Anderson FA Jr, et al. Prevention of venous thromboembolism. Chest 2001;119:132S–175S.
PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism. JAMA 1990;263:2753–2759.
Guidelines for the diagnosis, treatment and prevention for pulmonary thromboembolism and deep vein thrombosis. Circ J 2004;68(suppl IV):1079–1152
Guidelines on diagnosis and management of acute pulmonary embolism. Task Force on Pulmonary Embolism, European Society of Cardiology. Eur Heart J 2000;21:1301–1336.
Sacco RL, Adams R, Albers G, Alberts MJ, Benavente O, Furie K, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on stroke cosponsored by the council on cardiovascular radiology and intervention. Stroke 2006;37:577–617.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sakai, T., Ogura, Y., Kimura, D. et al. Pulmonary embolism and cerebral venous thrombosis after thoracoscopic surgery for benign pulmonary disease. Gen Thorac Cardiovasc Surg 56, 570–574 (2008). https://doi.org/10.1007/s11748-008-0303-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-008-0303-2