Key result
Emergency interventional thrombolysis successfully resolves isolated bilateral PE following knee arthroscopy.
Why the study?
Symptomatic pulmonary embolism after knee arthroscopy is extremely rare, and bilateral PE without concomitant deep vein thrombosis has never been reported following routine knee arthroscopy.
Case Report (n=1)
This case highlights the rare occurrence of bilateral pulmonary embolism without deep vein thrombosis after routine knee arthroscopy, emphasizing the need for timely diagnosis and effective treatment.
Supports interventional thrombolysis for rare post-arthroscopy PE without DVT; single case leaves open need for confirmatory studies.
BACKGROUND: Symptomatic pulmonary embolism (PE) after knee arthroscopy is extremely rare. If the embolism is not treated promptly, the patient may die. Bilateral pulmonary embolism with associated pulmonary infarct without concomitant deep vein thrombosis has never been reported following routine knee arthroscopy. CASE PRESENTATION: A 50-year-old female patient with no other risk factors other than hypertension, obesity, varicose veins in the ipsilateral lower extremities and elevated triglyceride (TG) presented to our ward. She had experienced sudden chest tightness, polypnea and fainting after going to the bathroom the morning of the second postoperative day and received emergency medical attention. Colour ultrasonography of the extremities showed no deep vein thrombosis. Lung computed tomography angiography (CTA) showed multiple embolisms scattered in both pulmonary artery branches. Thus, emergency interventional thrombolysis therapy was performed, followed by postoperative symptomatic treatment with drugs with thrombolytic, anticoagulant and protective activities. One week later, lung CTA showed a significant improvement in the PEs compared with those in the previous examination. Since the aetiology of PE and no obvious symptoms were discerned, the patient was discharged. CONCLUSION: Although knee arthroscopy is a minimally invasive and quick procedure, the risk factors for PE in the perioperative period should be considered and fully evaluated to enhance PE detection. Moreover, a timely diagnosis and effective treatment are important measures to prevent and cure PE after knee arthroscopy. Finally, clear guidelines regarding VTE thromboprophylaxis following knee arthroscopy in patients with a low risk of VTE development are needed.
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Li et al. (2021) conducted a case report in Bilateral pulmonary embolism without deep venous thrombosis (n=1). Emergency interventional thrombolytic therapy was evaluated on Improvement of pulmonary emboli. Emergency interventional thrombolysis therapy successfully treated a rare case of bilateral pulmonary embolism without deep venous thrombosis in a 50-year-old woman following knee arthroscopy.
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