Background: There are several recent reports that left upper lobe lung resection is a risk factor for the development of\npostoperative thromboembolism. Although administering epidural analgesia is common in thoracic surgery,\nanesthesiologists should be alert when administering epidural analgesia to a patient undergoing left upper\nlobectomy, considering the increased risk of postoperative thromboembolism and the potential need for\nanticoagulation or fibrinolytic therapy in the immediate postoperative period.\nCase presentation: A seventy-one-year-old female with a metastatic lung lesion developed a cerebral infarction\napproximately 30 h after video-assisted thoracoscopic left upper lobectomy. Cerebral intravascular therapy was\nindicated and the epidural catheter was removed immediately to avoid formation of an epidural hematoma.\nApproximately four hours after onset, reperfusion was successfully established by aspiration of endovascular thrombi.\nShe recovered with mild residual paralysis of the left upper extremity and was transferred to a rehabilitation facility.\nConclusions: We present a patient with a cerebral infarction after left upper lobectomy. Left upper lobectomy is\nassociated with an increased risk of postoperative thromboembolism. Although the exact mechanism of thrombosis\nafter left upper lobectomy is unclear, a judicious decision should be made regarding epidural catheter placement for\npostoperative analgesia.
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