A New Noninvasive Management Strategy for Patients With Suspected Pulmonary Embolism

Hull, Russell D.; Raskob, Gary E.; Coates, Geoffrey; Panju, Akbar; Gill, Gerald

doi:10.1001/archinte.1989.00390110105024

Cited by 150 publications

(38 citation statements)

References 33 publications

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“…Therefore, the institution of long-term anticoagulant therapy without performance of pulmonary angiography is acceptable [6,9]. Pulmonary angiography should be reserved for patients with vital contraindications for anticoagulants or those in whom there is strong suspicion of the presence of a disorder other than pulmonary embolism.…”

Section: High Probability Perfusion-ventilation Lung Scanmentioning

confidence: 99%

“…In a large prospective management study of 874 patients, deep vein thrombosis was detected using impedance plethysmography in 19%, 8% and 1% of patients with a high probability, non-high probability and normal lung scan result respectively [9]. Serial impedance plethysmography up to 2 weeks was performed in 371 patients with a non-high probability lung scan result, and deep vein thrombosis was detected in nine (2%).…”

Section: Non-invasive Tests For Venous Thromboembolismmentioning

confidence: 99%

“…None of the remaining 362 patients received oral anticoagulants; ten (2.7%) returned with symptomatic and objectively documented venous thromboembolism within 3 months, but none of them died. Thus, the use of noninvasive techniques for the detection of deep vein thrombosis has been advocated in the management of patients with a non-high probability lung scan result [9,21,[79][80][81]. However, so far only one prospective management study has been performed and confirmatory studies are urgently required before this approach is generally recommended.…”

Section: Non-invasive Tests For Venous Thromboembolismmentioning

confidence: 99%

“…van Beek recent studies have investigated the additional value of non-invasive (blood) tests in the exclusion or demonstration of thromboembolic disease in patients with abnormal but non-diagnostic lung scan results [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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The value of lung scintigraphy in the diagnosis of pulmonary embolism

et al. 1993

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The role of lung scintigraphy in the diagnostic management of patients with clinically suspected pulmonary embolism is reviewed. Evidence is provided that a normal perfusion scan excludes clinically relevant pulmonary embolism, and that a high probability lung scan, defined as a segmental perfusion defect with locally normal ventilation, sufficiently confirms the presence of pulmonary embolism in the majority of these patients. Furthermore, this review assesses the possibility of non-invasive tests for the diagnosis or exclusion of venous thromboembolic disease as a means of avoiding pulmonary angiography in patients with lung scan outcomes that are neither normal nor high probability.

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Section: High Probability Perfusion-ventilation Lung Scanmentioning

confidence: 99%

Section: Non-invasive Tests For Venous Thromboembolismmentioning

confidence: 99%

Section: Non-invasive Tests For Venous Thromboembolismmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The value of lung scintigraphy in the diagnosis of pulmonary embolism

et al. 1993

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“…Other important factors include the severity of preexisting cardiopulmonary dysfunction and the peripheral venous clot burden, which signifies the potential of recurrent thromboembolic events [15,33]. The interactions of these factors result in the development of pulmonary artery hypertension and right ventricular pressure overload.…”

Section: The Bleeding Risk Associated With Thrombolytic Treatmentmentioning

confidence: 99%

The case for thrombolysis in acute major pulmonary embolism: hemodynamic benefits and beyond

Konstantinides

2002

Intensive Care Medicine

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The Role of Spiral Volumetric Computed Tomography in the Diagnosis of Pulmonary Embolism

Mullins

Becker²,

Hagspiel³

et al. 2000

Arch Intern Med

187

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To evaluate the evidence for the use of spiral volumetric computed tomography (SVCT) in the diagnosis of acute pulmonary embolism (PE), the 11 English-language studies published through July 1998 that compared SVCT with a reference standard for PE were systematically reviewed. Among the reviewed studies, methodological problems were common. Only 5 of these studies fulfilled 5 of 11 basic standards addressing important issues in diagnostic test research. The reported sensitivities of SVCT compared with pulmonary angiography varied widely (64%-93%), which was likely the result of differences in study populations. Spiral volumetric computed tomography may be relatively sensitive and specific for diagnosing central pulmonary artery PEs, but it is insensitive for diagnosing subsegmental clots. Spiral volumetric computed tomography may have a role as a "rule-in" test for large central emboli, but additional research is required to establish its place in clinical practice.

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A New Noninvasive Management Strategy for Patients With Suspected Pulmonary Embolism

Cited by 150 publications

References 33 publications

The value of lung scintigraphy in the diagnosis of pulmonary embolism

The value of lung scintigraphy in the diagnosis of pulmonary embolism

The case for thrombolysis in acute major pulmonary embolism: hemodynamic benefits and beyond

The Role of Spiral Volumetric Computed Tomography in the Diagnosis of Pulmonary Embolism

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