PMC9204137_01
(A) Superior vena cava filter (SVCF) implantation. Vena cava filter (red oval) was on the position. (B) Superior vena cava filter removal. There was no spillover of contrast agent (blue oval).
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F1
Considering that venous thrombus might fall off, causing severe thromboembolism events, such as PE and post-embolization syndrome, SVCF implantation was performed under digital subtraction angiography on day 3 after admission (Figure 1A). Intraoperative re-examination showed that the upper vena cava was smooth (Figure 1B).
(A) Computed tomographic pulmonary angiography (CTPA). Pericardial effusion or hemorrhage (red arrow) and a small volume of pleural effusion (blue arrow) were observed. (B) Echocardiography at 12 h after SVCF removal. (C) Computed tomographic venography (CTV) of the upper limb vein. The right axillary vein was not filling well (red arrow).
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F2
However, pericardial effusion or hemorrhage and a small volume of pleural effusion were observed (Figure 2A). In addition, an echocardiogram showed a medium liquid dark area in the pericardial cavity, 17 mm in front of the anterior wall of the right ventricle, 16 mm behind the posterior wall of the left ventricle, 9 mm at the apex, 17 mm outside the lateral wall of the left ventricle, and 14 mm outside the lateral wall of the right ventricle (Figure 2B). Thus, thrombosis was highly suspected (Figure 2C).
Aortic dissection.
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F3
Computed tomography angiography (CTA) of the whole aorta revealed aortic dissection (Stanford type A), which involved the aortic valve (Figure 3).