Why the study?
Systemic thromboembolism from pulmonary vein stump thrombus usually presents as cerebral infarction after left upper lobectomy, making acute limb ischemia after left lower lobectomy a rare presentation to document.
Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism such as acute limb ischemia.
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May warrant vigilance for embolic limb ischemia after LLL; extends PV-stump risk beyond LUL and leaves prophylaxis unestablished.
BACKGROUND: Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy. CASE PRESENTATION: A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications. CONCLUSIONS: Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.
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Fujimoto et al. (2021) studied this question.
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