{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:57:20Z","timestamp":1767679040516,"version":"3.48.0"},"reference-count":9,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,17]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>We highlight the complex management considerations in a patient with cerebral amyloid angiopathy who developed venous thromboembolism, explicitly navigating the balance between risks of thromboembolism and bleeding with anticoagulation therapy. This case highlights a man in his 70s who presented to the emergency department with an acute right frontal intracerebral haemorrhage secondary to cerebral amyloid angiopathy with an acute segmental pulmonary embolism managed with an inferior vena cava (IVC) filter. During hospitalisation, the patient developed a large expansile thrombus extending inferior from the IVC filter to the right popliteal vein. This necessitated the initiation of anticoagulation therapy, beginning with unfractionated heparin, transitioning to enoxaparin and ultimately to apixaban. He was treated with 3 months of anticoagulation with no haemorrhagic complications. The patient\u2019s successful outcome underscored the potential for safe and effective anticoagulation management in this complex clinical scenario.<\/jats:p>","DOI":"10.1136\/bcr-2025-268377","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:19Z","timestamp":1767678619000},"page":"e268377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of an inferior vena cava thrombus with comorbid intracranial haemorrhage and cerebral amyloid angiopathy"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7034-4923","authenticated-orcid":false,"given":"Keir","family":"MacKay","sequence":"first","affiliation":[{"name":"Hospital Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2348-1017","authenticated-orcid":false,"given":"Christopher A","family":"Dinh","sequence":"additional","affiliation":[{"name":"Hospital Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7858-1317","authenticated-orcid":false,"given":"Sagar B","family":"Dugani","sequence":"additional","affiliation":[{"name":"Hospital Internal Medicine, Mayo Clinic Rochester, Rochester, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"2026010521501319000_19.1.e268377.1","first-page":"2095","article-title":"Diagnosis of cerebral amyloid angiopathy: sensitivity and specificity of cortical biopsy","volume":"28","author":"Rosenblum","year":"1997","journal-title":"Stroke"},{"key":"2026010521501319000_19.1.e268377.2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008590"},{"key":"2026010521501319000_19.1.e268377.3","first-page":"1472","article-title":"Association of apolipoprotein E \u03b52 and \u03b54 alleles with cerebral amyloid angiopathy and related hemorrhage","volume":"26","author":"Greenberg","year":"1995","journal-title":"Stroke"},{"key":"2026010521501319000_19.1.e268377.4","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12247704","article-title":"When Atrial Fibrillation Meets Cerebral Amyloid Angiopathy: Current Evidence and Strategies","volume":"12","author":"Merella","year":"2023","journal-title":"J Clin Med"},{"key":"2026010521501319000_19.1.e268377.5","doi-asserted-by":"crossref","first-page":"i64","DOI":"10.1093\/eurheartjsupp\/suae020","article-title":"Cerebral haemorrhage in the patient with atrial fibrillation: do we employ the direct oral anticoagulants without waiting too long?","volume":"26","author":"Vassiliki\u2019 Coutsoumbas","year":"2024","journal-title":"Eur Heart J Suppl"},{"key":"2026010521501319000_19.1.e268377.6","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2020001830"},{"key":"2026010521501319000_19.1.e268377.7","doi-asserted-by":"crossref","first-page":"S214","DOI":"10.1016\/j.jacr.2019.02.010","article-title":"ACR Appropriateness Criteria\u00ae Radiologic Management of Venous Thromboembolism-Inferior Vena Cava Filters","volume":"16","author":"Minocha","year":"2019","journal-title":"J Am Coll Radiol"},{"key":"2026010521501319000_19.1.e268377.8","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1002\/ana.27253","article-title":"Prevalence of Cerebral Amyloid Angiopathy and Associated Risk of Subsequent Ischemic and Hemorrhagic Stroke and Mortality in a Nationwide Cohort","volume":"98","author":"Bruce","year":"2025","journal-title":"Ann Neurol"},{"key":"2026010521501319000_19.1.e268377.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.011"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:50:21Z","timestamp":1767678621000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,5]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-268377"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268377","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}