TY - JOUR
AR - JSO-2021-2-105
TI - Intraoperative Thrombolysis for Pulmonary Embolism during Thymoma Resection
AU - Georgios, Stefanakis
AU - Vasileia, Nyktari
AU - Georgios, Papastratigakis
AU - Panagiotis, Vardakis
AU - Periklis, Vasilos
AU - Emmanouela, Koutoulaki
JO - Journal of Surgical Oncology
PY - 2021
DA - Wed 20, Oct 2021
SN - 2674-3000
DO - http://dx.doi.org/10.31487/j.JSO.2021.02.05
UR - https://www.sciencerepository.org/intraoperative-thrombolysis-for_JSO-2021-2-105 
KW - Superior vena cava syndrome, pulmonary embolism, thrombolytic therapy, postoperative blindness
AB - We report a case of pulmonary embolism during resection of a mediastinal mass requiring intraoperative thrombolysis. The diagnosis, although difficult to establish due to simultaneous bleeding and technical difficulties with transthoracic echocardiography, was based on the patient’s history and clinical evidence of low cardiac output and was confirmed by clinical improvement post thrombolysis. When awakened in the intensive care unit, the patient was found to be blind and also required a tracheostomy. We present this case, as it requires complex clinical reasoning throughout different stages of its management and it demonstrates that, when facing an imminent disaster, a risky decision not necessarily conforming to current practice but based on individualisation of treatment can be life-saving.