Embolization of a Symptomatic Systemic to Pulmonary (Right-to-left) Venous Shunt Caused by Fibrosing Mediastinitis and Superior Vena Caval Occlusion JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY Sze, D. Y., Fleischmann, D., Ma, A. O., Price, E. A., McConnell, M. V. 2010; 21 (1): 140-143


Paradoxical embolization can occur when a right-to-left shunt allows a venous thromboembolus to escape filtration by the lungs. Venous collateral pathways draining into the left heart incited by superior vena cava obstruction are a rare acquired right-to-left shunt. Herein, the authors report on a case of transient ischemic attack in a patient with vena caval occlusion secondary to histoplasmosis-related fibrosing mediastinitis, with subclavian vein thrombosis and a right-to-left extracardiac shunt diagnosed with echocardiography. Despite the complexity of the collateral network, this shunt was successfully eradicated with coil embolization.

View details for DOI 10.1016/j.jvir.2009.09.022

View details for PubMedID 20123198