{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:33:08Z","timestamp":1793410388202,"version":"4.5.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin intervent Radiol"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Patent foramen ovale (PFO) is a common congenital abnormality of high prevalence in adults. Its clinical significance is magnified in a right-to-left shunt, where paradoxical embolism can have catastrophic outcomes involving the brain, heart, mesenteric circulation, or extremities. Right-to-left shunting through a PFO is caused by increased right atrial pressure, as seen in the setting of pulmonary artery hypertension or pulmonary embolism. This case highlights the relevance of central venous catheter placement in the setting of a PFO. While the patient did not experience clinical sequelae from line placement, she was at high risk for paradoxical embolus. Recognizing the possibility of a PFO during central venous catheter placement, especially in the setting of increased right pressures, should be a consideration of all interventional radiologists.<\/jats:p>","DOI":"10.1055\/s-0043-1769745","type":"journal-article","created":{"date-parts":[[2023,7,20]],"date-time":"2023-07-20T22:37:30Z","timestamp":1689892650000},"page":"304-307","source":"Crossref","is-referenced-by-count":1,"title":["Malposition of a Femoral Tunneled Dialysis Catheter through a Patent Foramen Ovale"],"prefix":"10.1055","volume":"40","author":[{"given":"Anthony Finnay","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina P.","family":"Landinez","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert K.","family":"Kerlan","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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Vasc Interv Radiol"},{"issue":"06","key":"ref3","doi-asserted-by":"crossref","first-page":"E98","DOI":"10.1177\/1076029610387123","article-title":"Paradoxical arterial embolism involving both upper extremities in a patient with pulmonary embolism and a patent foramen ovale","volume":"17","author":"O S Kouskov","year":"2011","journal-title":"Clin Appl Thromb Hemost"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"887","DOI":"10.7326\/0003-4819-119-9-199311010-00004","article-title":"Positive end-expiratory pressure increases the right-to-left shunt in mechanically ventilated patients with patent foramen ovale","volume":"119","author":"B Cujec","year":"1993","journal-title":"Ann Intern Med"},{"issue":"06","key":"ref5","doi-asserted-by":"crossref","first-page":"1515","DOI":"10.1378\/chest.101.6.1515","article-title":"Detection of patent foramen ovale by contrast transesophageal echocardiography","volume":"101","author":"W J 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Nwosu","year":"2021","journal-title":"Cureus"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1053\/j.ajkd.2019.12.001","article-title":"KDOQI clinical practice guideline for vascular access: 2019 update","volume":"75","author":"C E Lok","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"ref16","volume-title":"Plastics in Medical Devices for Cardiovascular Applications","author":"A D Padsalgikar","year":"2017"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"2054358116669128","DOI":"10.1177\/2054358116669128","article-title":"Practical aspects of nontunneled and tunneled hemodialysis catheters","volume":"3","author":"E Clark","year":"2016","journal-title":"Can J Kidney Health Dis"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1093\/ndt\/gfp660","article-title":"Experience of 70-cm-long femoral tunnelled twin Tesio catheters for chronic haemodialysis","volume":"25","author":"S V Bertoli","year":"2010","journal-title":"Nephrol Dial Transplant"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"493","DOI":"10.2214\/ajr.172.2.9930810","article-title":"Experience with tunneled femoral hemodialysis catheters","volume":"172","author":"G X Zaleski","year":"1999","journal-title":"AJR Am J Roentgenol"},{"issue":"06","key":"ref21","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1111\/j.1523-1755.2005.00762.x","article-title":"Outcomes of tunneled femoral hemodialysis catheters: comparison with internal jugular vein catheters","volume":"68","author":"I D Maya","year":"2005","journal-title":"Kidney Int"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1385\/NCC:2:2:185","article-title":"Central venous catheter thrombosis complicated by paradoxical embolism in a patient with diabetic ketoacidosis and respiratory failure","volume":"2","author":"J A Batsis","year":"2005","journal-title":"Neurocrit 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