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Review
. 2015 Jul;16(4):489-96.
doi: 10.5811/westjem.2015.5.25553. Epub 2015 Jul 10.

Approach to Management of Intravascular Missile Emboli: Review of the Literature and Case Report

Kevin Lu  1 , Sanjay Gandhi  2 , Moqueet A Qureshi  3 , Andrew S Wright  4 , Narongrit Kantathut  5 , Thomas P Noeller  4
Affiliations
Review

Approach to Management of Intravascular Missile Emboli: Review of the Literature and Case Report

Kevin Lu et al. West J Emerg Med. 2015 Jul.
No abstract available

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Figures

Figure 1
Figure 1
Chest radiograph showing blurred foreign body within the cardiac silhouette (arrow).
Figure 2
Figure 2
Chest computed tomograph showing bullet (arrow) in the right ventricle, both transverse (Figure 2a) and sagittal (Figure 2b) views showing significant glare.
Figure 2
Figure 2
Chest computed tomograph showing bullet (arrow) in the right ventricle, both transverse (Figure 2a) and sagittal (Figure 2b) views showing significant glare.
Figure 3
Figure 3
Transesophageal echocardiogram views of right ventricular (RV) apical view (Figure 3a [top]; arrow as bullet tip in RV trabeculae) and RV transverse view (Figure 3b [bottom]; arrow as bullet demonstrating significant comet tail artifact).
Figure 3
Figure 3
Transesophageal echocardiogram views of right ventricular (RV) apical view (Figure 3a [top]; arrow as bullet tip in RV trabeculae) and RV transverse view (Figure 3b [bottom]; arrow as bullet demonstrating significant comet tail artifact).
Figure 4
Figure 4
Fluoroscopy intraoperatively showing snare (black arrow) next to bullet (white arrow) and transesophageal echocardiogram probe.
Figure 5
Figure 5
A model of missile embolus management by anatomical location based on review of the literature and authors’ own experiences. CT, computed tomography; CXY, chest x-ray; IVC, inferior vena cava; FAST, focused assessment with sonography for trauma
See this image and copyright information in PMC

References

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    1. Rich NM, Collins GJ, Andersen CA, et al. Missile emboli. J Trauma. 1978;18(4):236–9. - PubMed
    1. Aidinian G, Fox CJ, Rasmussen TE, et al. Varied presentations of missile emboli in military combat. J Vasc Surg. 2010;51(1):214–217. - PubMed
    1. Khanna A, Drugas GT. Air gun pellet embolization to the right heart: case report and review of the literature. J Trauma. 2003;54(6):1239–41. - PubMed