Brachial embolism from mechanical mitral valve thrombosis: multimodality imaging-guided successful thrombolysis

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Abstract

We report the administration of low-dose (25 mg) prolonged infusion (25 h) of tissue-typed plasminogen activator (t-PA) in the treatment of brachial arterial thromboembolism (BAT) secondary to prosthetic valve thrombosis (PVT), under the guidance of multimodality imaging. BAT is a rare disorder with serious consequences. The case of BAT secondary to mitral PVT was successfully treated with low-dose prolonged infusion of t-PA under the guidance of multimodality imaging with upper extremity duplex Doppler ultrasonography, multislice computerized tomographic angiography, coventional angiography and advanced transesophageal echocardiography. This case has demonstrated that low-dose prolonged infusion of t-PA may be adequate in the treatment of BAT.

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