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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Usefulness of Oral Xa Inhibitor for Management of Ischemic Stroke Associated with Thrombosis in the Pulmonary Vein Stump after Lung Resection
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Usefulness of Oral Xa Inhibitor for Management of Ischemic Stroke Associated with Thrombosis in the Pulmonary Vein Stump after Lung Resection

机译：肺切除后肺静脉树桩血栓形成缺血性脑卒中管理的口腔XA抑制剂的有用性

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Objectives: Brain infarction is a critical complication after lung resection using video-assisted thoracoscopic surgery. Recent reports have described its association with thrombosis in the pulmonary vein (PV) stump. However, the optimal management of this complication remains controversial. We describe serial 3 cases of brain infarctions associated with thrombosis in the PV stumps, which were successfully treated with the oral Xa inhibitor rivaroxaban. Methods and Results: We retrospectively reviewed medical records of 3 patients. The first case was a 72-year-old man who underwent left upper lobectomy for treatment of lung adenocarcinoma. The second case was a 55-year-old man who underwent right lower segmentectomy for treatment of metastatic tumor from Barrett's esophageal carcinoma. The third case was a 73-year-old man who underwent left upper lobectomy for treatment of metastatic tumor from colon adenocarcinoma. In the first case, a large cerebellar infarction was developed and a decompressive craniotomy was performed on postoperative day 4. In the second and the third case, cerebral infarctions in the territories of right middle cerebral arteries occurred on postoperative day 2. In all cases, contrast-enhanced computed tomography demonstrated the thrombi in the stumps of the PVs. They were treated with oral administration of rivaroxaban without adverse effect, and the thrombi in the PVs disappeared within 1 month. Discussion: Blood flow stasis in the long PV stump after lung resection might contribute to thrombosis development. Oral Xa inhibitor rivaroxaban appeared to be safe and useful for the management of ischemic stroke associated with PV thrombosis after lung resection.
机译：目标：使用视频辅助胸腔镜手术肺切除后脑梗塞是一种关键并发症。最近的报告已经描述了其与肺静脉（PV）树桩中的血栓形成相关性。然而，这种并发症的最佳管理仍然存在争议。我们描述了与PV树桩中血栓形成相关的脑梗塞的连续3例，用口腔XA抑制剂rivaroxaban成功处理。方法和结果：我们回顾性地审查了3名患者的病历。第一个案例是一个72岁的男子，接受左上肺切除术治疗肺腺癌。第二个案例是一名55岁的男子，接受右下细分切除术治疗来自巴雷特食管癌的转移性肿瘤。第三个案例是一个73岁的男子，接受左上肺切除术治疗来自结肠腺癌的转移性肿瘤。在第一种情况下，开发了大脑梗塞，并且在术后第4天进行了一种减压的Craniotomy。在第二个和第三种情况下，术后第2天发生了右中脑动脉的地区的脑梗塞。在所有情况下，对比度增强的计算机断层扫描在PVS的树桩中显示出血栓。它们被口服施用的rivaroxaban治疗而没有不良影响，PVS中的血栓在1个月内消失。讨论：肺切除后长型光伏树桩中的血流瘀血可能导致血栓形成发育。口腔XA抑制剂Rivaroxaban似乎是安全的，可用于治疗肺切除后与光伏血栓形成相关的缺血性卒中。

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