Intra-arterial air thrombogenesis after cerebral air embolism complicating lower extremity sclerotherapy

Neurocrit Care. 2009;11(2):247-50. doi: 10.1007/s12028-009-9211-2. Epub 2009 Mar 17.

Abstract

Background: Cerebral arterial gas embolism is a potentially life-threatening event. Intraarterial air can occlude blood flow directly or cause thrombosis. Sclerotherapy is an extremely rare cause of cerebral arterial gas embolism.

Method: Case-report

Results: A 38-year-old female suffered acute onset of a left middle cerebral artery (LMCA) syndrome with an NIH stroke score of 11 approximately 10 min after lower extremity sclerotherapy. CT angiogram demonstrated LMCA intraarterial air. Patient fully recovered after hyperbaric oxygen treatment with complete resolution of intraarterial air. However, thrombus replaced intraarterial air despite anticoagulation with heparin.

Conclusion: We provide radiological evidence of hyperbaric oxygen therapy resolving intraarterial air but also demonstrate the thrombogenic potential of this procedural complication.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Embolism, Air / etiology*
  • Female
  • Humans
  • Hyperbaric Oxygenation
  • Intracranial Embolism / diagnostic imaging
  • Intracranial Embolism / etiology
  • Intracranial Embolism / therapy
  • Middle Cerebral Artery / diagnostic imaging
  • Sclerosing Solutions / adverse effects
  • Sclerosing Solutions / therapeutic use
  • Sclerotherapy / adverse effects
  • Sodium Tetradecyl Sulfate / adverse effects
  • Tomography, X-Ray Computed
  • Varicose Veins / therapy*

Substances

  • Sclerosing Solutions
  • Sodium Tetradecyl Sulfate