CTICasesParadoxical Embolus
Imaging findings
Runoff CT angiogram shows a filling defect (acute embolus) in the right popliteal artery without atherosclerosis. Chest CT shows a pulmonary embolism. Echocardiography confirmed a patent foramen ovale (PFO), indicating a paradoxical embolism.
Key takeaways
Paradoxical embolism occurs when a venous thrombus (DVT) bypasses the pulmonary circulation via a right-to-left shunt (most commonly a PFO) and enters the systemic arterial circulation, presenting as acute limb ischemia.
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