Scipediacontent: Scipediacontent moved page Draft Content 980911243 to Takeuchi 2015d

2017-05-19T09:48:48Z

Scipediacontent moved page Draft Content 980911243 to Takeuchi 2015d

Scipediacontent: Created page with " ==Keywords== Pulmonary vein thrombus;64-MDCT;Left atrial thrombus;Stroke Ischemic stroke is a serious clinical problem [1] ; [2]. To prevent is..."

2017-05-19T09:45:10Z

Created page with " ==Keywords== Pulmonary vein thrombus;64-MDCT;Left atrial thrombus;Stroke Ischemic stroke is a serious clinical problem [1] ; [2]. To prevent is..."

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==Keywords==

Pulmonary vein thrombus;64-MDCT;Left atrial thrombus;Stroke

Ischemic stroke is a serious clinical problem [[#bb0030|[1]]] ; [[#bb0010|[2]]]. To prevent ischemic stroke, it is crucial to identify clinical targets. Left atrial thrombus is a known cause of ischemic stroke [[#bb0010|[2]]] ; [[#bb0015|[3]]]; however, the cause of left atrial thrombus remains unknown.

Pulmonary vein thrombosis (PVT) is thought to be rare; however, I have published several cases of PVT in elderly patients with chest pain using a 64-slice multidetector CT (64-MDCT) since 2012 [[#bb0035|[4]]]; [[#bb0025|[5]]]; [[#bb0040|[6]]]; [[#bb0045|[7]]]; [[#bb0050|[8]]]; [[#bb0055|[9]]] ; [[#bb0060|[10]]]. In 2014, I reported that 61% (35 patients) of 57 elderly patients with chest pain had PVT, as assessed using 64-MDCT, which suggests that PVT is common in elderly patients with chest pain [[#bb0055|[9]]]. Although I have reported that a thrombus in the pulmonary vein extends into the left atrium [[#bb0025|[5]]]; [[#bb0040|[6]]]; [[#bb0050|[8]]] ; [[#bb0055|[9]]], the relationship between PVT and a left atrial thrombus remains unknown.

I reviewed the images of 64-MDCT scans obtained from 35 patients with PVT. Seventeen patients (49%) had a thrombus in the left atrium, which was extended from pulmonary vein thrombi, indicating that approximately half of patients with PVT had a left atrial thrombus. In addition, among the 22 patients without PVT, only three patients (14%) had a left atrial thrombus. These three patients may have a fine pulmonary vein thrombus, which could not be clearly visualized using 64-MDCT. Thus, there is a possibility that nearly all left atrial thrombi are extended from pulmonary vein thrombi. Nearly all left atrial thrombi may use pulmonary vein thrombi as a root, which may provide a strong structure in the thrombi. In addition, I reported that some of the thrombi were partially dissolved within three months following warfarin [[#bb0035|[4]]] and dabigatran [[#bb0045|[7]]]; [[#bb0050|[8]]] ; [[#bb0055|[9]]] treatment, indicating that warfarin and dabigatran could prevent ischemic stroke by dissolving the pulmonary vein thrombus and the connected left atrial thrombus. However, not all thrombi were dissolved upon warfarin [[#bb0025|[5]]] and dabigatran [[#bb0060|[10]]] treatment, and thus, more efficient anti-coagulants are needed to prevent ischemic stroke.

==Conflict of interest==

The authors report no relationships that could be construed as a conflict of interest.

==References==

<ol style='list-style-type: none;margin-left: 0px;'><li>
[[#bb0030|[1]]] K. Strong, C. Mathers, R. Bonita; Preventing stroke: saving lives around the world; Lancet Neurol, 6 (2007), pp. 182–188</li>
<li>
[[#bb0010|[2]]] P.A. Wolf, R.D. Abbott, W.B. Kannel; Atrial fibrillation as an independent risk factor for stroke: the Framingham Study; Stroke, 22 (1991), pp. 983–988</li>
<li>
[[#bb0015|[3]]] J.L. Blackshear, J.A. Odell; Appendage obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation; Ann Thorac Surg, 61 (1996), pp. 755–759</li>
<li>
[[#bb0035|[4]]] H. Takeuchi; A thrombus of the right upper pulmonary vein: detection by the use of a 64-MDCT; BMJ Case Rep (Sep 14 2012) [https://doi.org/10.1136/bcr.12.2011.5446 https://doi.org/10.1136/bcr.12.2011.5446] [Published online:]</li>
<li>
[[#bb0025|[5]]] H. Takeuchi; 64-MDCT scan demonstrated pulmonary vein thrombus; J Neurol Neurophysiol, S8 (2013), p. 002 [https://doi.org/10.4172/2155-9562.S8-002 https://doi.org/10.4172/2155-9562.S8-002]</li>
<li>
[[#bb0040|[6]]] H. Takeuchi; 64-MDCT can depict the thrombi expanded from the left lower pulmonary vein to the left atrium in the patient with angina pectoris; BMJ Case Rep (Apr 3 2013) [https://doi.org/10.1136/bcr.2013-008750 https://doi.org/10.1136/bcr.2013-008750] [Published online:]</li>
<li>
[[#bb0045|[7]]] H. Takeuchi; Floating thrombus in the left upper pulmonary vein dissolved by dabigatran; BMJ Case Rep (Oct 9 2013) [https://doi.org/10.1136/bcr-2013-200836 https://doi.org/10.1136/bcr-2013-200836] [Published online:]</li>
<li>
[[#bb0050|[8]]] H. Takeuchi; Chest pain caused by pulmonary vein thrombi could be curable by dabigatran; BMJ Case Rep (March 13 2014) [https://doi.org/10.1126/bcr-2013-203186 https://doi.org/10.1126/bcr-2013-203186] [Published online:]</li>
<li>
[[#bb0055|[9]]] H. Takeuchi; High prevalence of pulmonary vein thrombi in elderly patients with chest pain, which has relationships with aging associated diseases; IJC Heart Vessels, 4 (2014), pp. 129–134 [https://doi.org/10.1016/j.ijchv.2014.05.006 https://doi.org/10.1016/j.ijchv.2014.05.006] [Published online: 6-JUN-2014]</li>
<li>
[[#bb0060|[10]]] H. Takeuchi; Pulmonary vein thrombi in a patient with paroxysmal atrial fibrillation; IJC Heart Vasculature, 5 (2014), pp. 63–64 [https://doi.org/10.1016/j.ijcha.2014.10.006 https://doi.org/10.1016/j.ijcha.2014.10.006]</li>
</ol>

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Takeuchi 2015d - Revision history

Scipediacontent: Scipediacontent moved page Draft Content 980911243 to Takeuchi 2015d

Scipediacontent: Created page with " ==Keywords== Pulmonary vein thrombus;64-MDCT;Left atrial thrombus;Stroke Ischemic stroke is a serious clinical problem [1] ; [2]. To prevent is..."