Clot In Transit in a Patient with Protein S Deficiency

  • Simon Kashfi CUNY School of Medicine, New York, NY, USA https://orcid.org/0000-0001-9947-7295
  • Mohamed Farhan Nasser Heart and Vascular Center, MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH, USA
  • Aron Soleiman Montefiore Medical Center, Bronx, NY, USA
  • Sapna Sharma St. Barnabas Hospital Health System, Bronx, NY, USA
  • Venkata Sandeep Koripalli Christus Good Shepherd Hospital, Longview, TX, USA
  • Shorabh Sharma St. Barnabas Hospital Health System, Bronx, NY, USA

Keywords

Clot in transit, pulmonary embolism, venous thromboembolism, thrombectomy

Abstract

Clot in transit (CIT) is a rare condition in which a venous thromboembolism becomes lodged in the right heart. It is seen in up to 18% of patients with massive pulmonary embolism, and if left untreated, mortality rates are between 80% and 100%. The identification and management of CIT are crucial. However, there are no current guidelines for the treatment of CIT. We present the case of a 44-year-old woman who was found to have CIT that was ultimately treated with medical management.

VIEW THE ENTIRE ARTICLE

References

  • Kabrhel C, Rosovsky R, Garvey S. Special considerations in pulmonary embolism. Crit Care Clin 2020 Jul;36(3):531–546.
  • Patel AK, Kafi A, Bonet A, Shapiro SM, Oh SS, Zeidler MR, et al. Resolution of a mobile right atrial thrombus complicating acute pulmonary embolism with low-dose tissue plasminogen activator in a patient with recent craniotomy. J Intensive Care Med 2016 Oct;31(9):618–621.
  • Turetz M, Sideris A, Friedman O, Triphathi N, Horowitz J. Epidemiology, pathophysiology, and natural history of pulmonary embolism. Semin Interv Radiol 2018 Jun;35(02):92–98.
  • Corrigan D, Prucnal C, Kabrhel C. Pulmonary embolism: the diagnosis, risk-stratification, treatment and disposition of emergency department patients. Clin Exp Emerg Med 2016 Sep 30;3(3):117–125.
  • Konstantinides SV, Meyer G, Becattini C, Geersing G-J, Harjola V-P, Huisman MV, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020 Jan 21;41(4):543–603.
  • Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M. Moderate pulmonary embolism treated with thrombolysis (from the “MOPETT” Trial). Am J Cardiol 2013 Jan;111(2):273–277.
  • Serna-Gallegos D, Sultan I. Commentary: clot in transit: catch it when you can. JTCVS Tech 2020 Dec;4:145–146.
  • Khanna S, Mehta A. Images in anesthesiology: a clot in transit. Anesthesiology 2018 Apr 1;128(4):810–810.
  • Garvey S, Dudzinski DM, Giordano N, Torrey J, Zheng H, Kabrhel C. Pulmonary embolism with clot in transit: an analysis of risk factors and outcomes. Thromb Res 2020 Mar;187:139–147.
  • Dhulipala VR, Fayoda BO, Kyaw H, Ayala-Rodriguez C. Thrombus in transit: extract or dissolve? Cureus2020 Aug;12(8):e9550.
  • Ruiz-Morales J, Kogler W, Ganji M, Sattiraju S. Clot in transit: a case of acute pulmonary embolism. BMJ Case Rep 2020 Aug;13(8):e236494.
  • Athappan G, Sengodan P, Chacko P, Gandhi S. Comparative efficacy of different modalities for treatment of right heart thrombi in transit: a pooled analysis. Vasc Med 2015 Apr;20(2):131–138.
  • Verma I, Chang EY, Kumar G, Sachdeva R. Catheter directed embolectomy of right atrial clot in transit - a case series. Catheter Cardiovasc Interv 2021 Apr 1;97(5):869–873.
  • Janus S, Hajjari J, Chami T, Karnib M, Osman MN. Clot in transit and pulmonary artery percutaneous mechanical thrombectomy. Kans J Med 2021 Nov 5;14:287–289.
  • Moriarty JM, Liao M, Kim GHJ, Yang E, Desai K, Ranade M, et al. Procedural outcomes associated with use of the AngioVac System for right heart thrombi: a safety report from RAPID registry data. Vasc Med 2022 Feb 17;1358863X211073974.
  • Published: 2022-05-05

    Issue: 2022: Vol 9 No 5 (view)

    Section: Articles

    How to cite:
    1.
    Kashfi S, Farhan Nasser M, Soleiman A, Sharma S, Sandeep Koripalli V, Sharma S. Clot In Transit in a Patient with Protein S Deficiency. EJCRIM 2022;9 doi:10.12890/2022_003355.

    Most read articles by the same author(s)