case_images: PMC8629915_01
case_images: (A) Computed tomography pulmonary angiography (CTPA) revealed acute bilateral PE, bilateral pleural effusion with partial dilatation of the lower lobes and multiple discrete pulmonary nodules. (B) Doppler ultrasound examination detected evidence of deep vein thrombosis (DVT) in the right posterior tibial vein. The right posterior tibial vein was dilated, about 10.6 mm at the deepest point, with hypoechoic filling.
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case_images: PMC8629915_01_CMAR-13-8849-g0001.jpg
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case_images: Doppler ultrasound were undergoing. CTPA revealed acute bilateral PE and bilateral pleural effusions (Figure 1A). Doppler ultrasound examination detected evidence of deep vein thrombosis (DVT) in the right posterior tibial vein (Figure 1B).
case_images: PMC8629915_02
case_images: Computed tomography scan revealed a thrombus floating in the left pulmonary artery and branches (A) with a bilateral femoral vein thrombosis (B). Digital subtraction angiography (DSA) showed inferior vena caval filters were implanted in the inferior vena at L2 level with luminal patency (C). Emergency computed tomography (CT) scan showed cerebral infarction (D).
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case_images: PMC8629915_02_CMAR-13-8849-g0002.jpg
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case_images: After three injections, two months after the initial treatment, a routine CT scan revealed an arterial thrombus floating in the left pulmonary artery and branches with a bilateral femoral vein thrombosis (Figure 2A and B). In the meantime, oral anticoagulation with rivaroxaban was given and inferior vena caval filters were implanted for preventing fatal PE (Figure 2C). Two months later, after receiving another 3 doses, the patient visited the emergency department for cerebral infarction (Figure 2D).