Spinal Epidural Hematoma after Attempted Catheter Thrombectomy of a Large Iliofemoral Deep Venous Thrombosis: A Case Report

摘要

The authors report the case of an 82-year-old womanwith a spinal epidural hematoma following attemptedcatheter-directed thrombolysis of a large femoralpoplitealdeep venous thrombosis. The patient rapidlydeveloped acute motor and sensory paralysis belowthe level of T7 within hours of the thrombectomy procedure.Computed tomography imaging revealed thatthe catheter had perforated the wall of the right inferiorvena cava and magnetic resonance imaging subsequentlydemonstrated an extensive T1-S1 dorsal epidural hematomawith compression of the thoracic spinal cord,conus medullaris, and cauda equina. Given the extent ofcord infarction and the risks of extensive thoracolumbarlaminectomy, decompression was not performed. The incidence,diagnosis, and management of anticoagulationassociatedspinal epidural hematoma as well as the indicationsfor catheter-directed thrombolysis of acute deepvenous thrombosis are reviewed.