Decision-making in a patient with cardiac arrest due to venous thromboembolism within 24 h after glioblastoma resection.

Dubinski, D; Won, S-Y; Bruder, M; Forster, M-T; Seifert, V; Senft, C; Berkefeld, J; Mersmann, J · Acta Neurochir (Wien) · 2016

case_report · Level V

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Abstract

In the fulminant VTE form with cardiac arrest, systemic thrombolysis remains the most effective therapy. However, several contraindications restrict the use such as intracranial neoplasm or a recent history of intracranial surgery. Here, we report the case of a 59-year-old man who underwent glioblastoma resection and suffered from a fulminant pulmonary embolism with cardiac arrest. After CPR, continuous tPA infusion via an endovascularly placed pulmonary catheter was maintained over a period of 8 h. In this case, we report on our decision-making process and the use of local thrombolysis as a successful therapy in a patient with multiple contraindications.

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