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Washington University Experience | VASCULAR | Infarct - Embolic | 20A0 Case 20 History
Cases 20-22 ---- The next 3 cases have in common the embolization of foreign materials found in patients who underwent vascular procedures (cardiac catherization, cerebral angiopathy for diagnosis and therapy) using hydrophilic-coated medical devices. (see Modern Pathology (2010) 23, 921–930)
Case 20 History
This patient was a 45 year old man with a past medical history of stage IV adenocarcinoma of the right lung, diffusely metastatic to bone including vertebrae, liver, with malignant pleural effusion status post IVC filter. He was scheduled for vertebroplasty, when he had acute onset of dysarthria, right gaze deviation and left sided weakness. Head CT showed complete right hemispheric stroke, edema and possible herniation. He was outside the tPA window, so thrombectomy was performed but clot still remained after 5 attempts at intravascular removal. He was then sent to the ICU and ultimately made comfort care after discussion with his family.
