Real-Time Capture of Thrombus Embolization During Point-of-Care Lower-Extremity Compression Ultrasonography.

Abstract

Compression ultrasonography is the bedside standard for diagnosing lower-extremity deep venous thrombosis. Probe-induced thrombus dislodgement, though rare, can precipitate pulmonary embolism, as well as strokes and other end-organ infarcts in patients with patent foramen ovales. We report a 65-year-old woman whose noncompressible mid-femoral deep venous thrombosis detached during routine point-of-care ultrasound-captured in real time-and resulted in bilateral subsegmental pulmonary emboli (PE) noted on computed tomography pulmonary angiography. The case highlights the possibility of compression-induced embolization, the need for controlled compression pressure, and immediate PE assessment when embolization is observed.