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seemingly contradictory but nonetheless possibly true; "it is paradoxical that standing is more tiring than walking" (同)self-contradictory

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/16 08:55:46」(JST)

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A paradoxical embolism, also called a crossed embolism, is a kind of stroke or other form of arterial thrombosis caused by embolism of a thrombus (blood clot) of venous origin through a lateral opening in the heart, such as a patent foramen ovale.^[1]

The opening is typically an atrial septal defect, but can also be a ventricular septal defect.

Paradoxical embolisms represent two percent of arterial emboli.^[2]

Pathophysiology

Passage of a clot (thrombus) from a vein to an artery. When clots in veins break off (embolize), they travel first to the right side of the heart and, normally, then to the lungs where they lodge, causing pulmonary embolism. On the other hand, when there is a hole at the septum, either upper chambers of the heart (an atrial septal defect) or lower chamber of the heart (ventricular septal defects), a clot can cross from the right to the left side of the heart, then pass into the arteries as a paradoxical embolism. Once in the arterial circulation, a clot can travel to the brain, block a vessel there, and cause a stroke (cerebrovascular accident).

References

^ Rakhit RD (November 2003). "Case 2: Patent foramen ovale (PFO) and paradoxical embolism". Heart 89 (11): 1362. doi:10.1136/heart.89.11.1362. PMC 1767929. PMID 18069145.
^ Tang CE (January 2004). "Paradoxical embolism: a rare life- and limb-threatening emergency". CJEM 6 (1): 40–4. PMID 17433144. ^{[dead link]}

This article about a medical condition affecting the circulatory system is a stub. You can help Wikipedia by expanding it.

UpToDate Contents

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1. 成人における心房中隔異常（PFO、ASD、およびASA）および脳塞栓症のリスク atrial septal abnormalities pfo asd and asa and risk of cerebral emboli in adults
2. 下肢の急性動脈閉塞（急性下肢虚血）の概要 overview of acute arterial occlusion of the extremities acute limb ischemia
3. Surgical and percutaneous closure of atrial septal defects in adults
4. Indications for closure and medical management of atrial septal defects in adults
5. Management of patients post-Fontan procedure

English Journal

Paradoxical embolus in transit.

Worku B1, Gulkarov I2, Steele J3, Kadosh B3, Skubas NJ4, Girardi LN5, Salemi A5.
The Annals of thoracic surgery.Ann Thorac Surg.2014 Aug;98(2):717-9. doi: 10.1016/j.athoracsur.2013.09.068.
Thrombus straddling a patent foramen ovale, namely, a paradoxical embolus in transit, is a rarely identified entity signifying impending arterial embolism. We report a series of 3 patients with preoperatively or intraoperatively identified paradoxical embolus in transit. All patients underwent surgi
PMID 25087801

Diagnostic yield of pelvic magnetic resonance venography in patients with cryptogenic stroke and patent foramen ovale.

Liberman AL1, Daruwalla VJ1, Collins JD1, Maas MB1, Botelho MP1, Ayache JB1, Carr J1, Ruff I1, Bernstein RA1, Alberts MJ1, Prabhakaran S2.
Stroke; a journal of cerebral circulation.Stroke.2014 Aug;45(8):2324-9. doi: 10.1161/STROKEAHA.114.005539. Epub 2014 Jun 17.
BACKGROUND AND PURPOSE: Paradoxical embolization is frequently posited as a mechanism of ischemic stroke in patients with patent foramen ovale. Several studies have suggested that the deep lower extremity and pelvic veins might be an embolic source in cryptogenic stroke (CS) patients with patent for
PMID 24938843