Education  |   January 2019
Images in Anesthesiology: Pulmonary Thromboembolism
Author Notes
  • From the Department of Anesthesiology and Critical Care (D.H.J., A.J.S., R.S.); and the Division of Interventional Radiology, Department of Radiology (A.S.), Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Address correspondence to Dr. Subramanyam: subramanyr@email.chop.edu
Article Information
Education / Images in Anesthesiology / Respiratory System
Education   |   January 2019
Images in Anesthesiology: Pulmonary Thromboembolism
Anesthesiology 1 2019, Vol.130, 149. doi:10.1097/ALN.0000000000002431
Anesthesiology 1 2019, Vol.130, 149. doi:10.1097/ALN.0000000000002431
Acute pulmonary embolism is a life-threatening event. The most frequent source of pulmonary embolism is iliofemoral deep venous thrombosis, shown in the femoral vein sonogram, as an echogenic density within the lumen with no intraluminal flow (arrow in image A). Supplemental Digital Content 1 (http://links.lww.com/ALN/B780) shows significant emboli occluding the right upper and middle lobe pulmonary arteries with near complete lack of perfusion of these two lobes (arrows in image B) on a pulmonary angiogram, a gold standard test for detecting pulmonary embolism. Supplemental Digital Content 2 (http://links.lww.com/ALN/B781) shows recanalization with prompt treatment using intraarterial and systemic tissue plasminogen activator and suction thrombectomy.