Current status of pulmonary thromboembolic disease: Pathophysiology, diagnosis, prevention, and treatment

Bell, William R.; Simon, Toby L.

doi:10.1016/0002-8703(82)90498-7

Cited by 232 publications

(74 citation statements)

References 123 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients with collapsed massive PE have an extremely high mortality rate 12,13) because conventional cardiopulmonary resuscitation including chest compression is usually not effective due to right ventricular outflow obstruction. ECLS provides a fundamental advantage in the treatment of collapsed massive PE because it provides the ability to decompress the acutely overloaded right atrium and ventricle, increase aortic pressure and hence myocardial perfusion pressure, increase myocardial blood flow, reverse ischemia, and consequently improve RV function.…”

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

et al. 2012

View full text Add to dashboard Cite

SummaryWhen pulmonary embolism (PE) develops, circulatory collapse and hypoxia are caused at the same time. The rapid and proper use of extracorporeal life support (ECLS) can improve the mortality rate of patients with collapsed massive PE. No study has examined the influence of treatment that involved adding catheter based-intervention to ECLS with massive collapsed PE. Thirty-five patients with massive PE were examined, and 10 of these patients were placed on ECLS. Eight of the 10 patients placed on ECLS for massive PE were female, and the median age was 61 years. Seven patients had in-hospital onset PE and 3 patients out-of-hospital onset PE. Their underlying conditions were a cerebral infarction (3 patients), coronary artery disease (5 patients), collagen disease (one patient), postoperative state (3 patients), and lung disease (2 patients). Pulmonary angiographic findings showed that a filling defect or complete occlusion was observed in all 10 patients in the proximal lobular arteries, 6 of which had large thrombi stretching to the main pulmonary arteries. All patients underwent thrombolysis. Percutaneous catheter embolus fragmentation and/or thrombectomy were undertaken in 7 patients. All patients required red blood cell transfusion for cannulation site bleeding. The mean duration of ECLS bypass was 48 ± 44 hours. The 30 day mortality rate was 30%. The current study clarified the characteristics of patients with massive PE requiring ECLS. These patients have extensive pulmonary thromboemboli, thus, the aggressive use of catheter-based intervention appears to have beneficial effects for massive PE requiring ECLS. (Int Heart J 2012; 53: 370-374)

show abstract

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

et al. 2012

View full text Add to dashboard Cite

show abstract

“…The difficulties in establishing an accurate diagnosis of pulmonary embolism represent a permanent challenge and deserve an extensive literature review 5,6 . Numerous studies have shown that many factors contribute to the difficulties in establishing the diagnosis of pulmonary embolism, including the pleomorphic clinical findings, the unspecific signs and symptoms, the presence of underlying conditions, the operational characteristics of the diagnostic tests and the pathological location of the embolus in the pulmonary tree.…”

Section: Discussionmentioning

confidence: 99%

“…Age has been repeatedly described as a risk factor for morbidity and mortality in pulmonary embolism, with an increased frequency in patients aged from 50 to 65 years and most deaths occurring in individuals older than 50 5 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fatal pulmonary embolism in hospitalized patients. Clinical diagnosis versus pathological confirmation

Mesquita¹,

Jl²,

Ft³

et al. 1999

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

Objective -To assess the incidence of fatal pulmonary embolism (FPE), the accuracy of clinical diagnosis, and the profile of patients who suffered an FPE in a tertiary University Hospital. Methods -Analysis of the records of 3,890 autopsies performed at the Department of General Pathology from January 1980 to December 1990. Results -The scarcity of Brazilian statistics makes us resort to using figures obtained from other countries in order to assess the magnitude of health problems in Brazil. Pulmonary embolism represents one of the best examples of the need for epidemiological investigation in our population.According to the most frequent estimates, pulmonary embolism accounts for 300 thousand hospitalizations and 50 thousand deaths annually in the United States of America 1 . In these studies conducted in the 50's, pulmonary embolism accounted for 3% of the deaths and was a contributing factor to 6% of all deaths. More recent investigations, such as the studies conducted by Morrel and Dunnill, have reported much higher incidences. According to these authors, pulmonary embolism alone accounts for 7% of adult deaths in general hospitals 2 .Autopsy studies have shown that approximately 40% to 60% of the individuals who die as a result of pulmonary embolism are not diagnosed with this condition when alive 3,4 . Approximately 10% of all patients with pulmonary embolism die within the first hour of symptom onset, precluding the use of more sophisticated diagnostic methods. In those who survive after the first hour, the prognosis is closely related to a correct diagnosis and therapy. Mortality is 5 to 6 times higher in those individuals who are not properly diagnosed and in whom the therapy is not instituted 5 .The significance of the figures mentioned above underscores the importance of recognizing the clinical features, the predisposing conditions and the natural history of this disease.We conducted a case-control study at the Department of Pathology of a university hospital to assess the incidence and the accuracy of the clinical diagnosis and the profile of the patients who suffered a fatal pulmonary embolism (FPE). MethodsWe reviewed the records of all autopsies performed on

show abstract

“…30,32,50 -52 This pattern of recurrence-with Ϸ3-fold higher risk of PE after an initial PE than after an initial DVT-appears persistent. 32,51 Approximately 10% of symptomatic PEs are rapidly fatal [53][54][55] and another 5% of those in whom PE is diagnosed and treated also die of it. 32,51,56 -59 Thus, after Ն3 months of treatment for DVT or PE, recurrent VTE presenting as PE has a case fatality rate of Ϸ15%.…”

Section: Pulmonary Embolism Versus Deep Vein Thrombosismentioning

confidence: 99%

Long-Term Management of Patients After Venous Thromboembolism

Kearon

2004

Circulation

113

View full text Add to dashboard Cite

show abstract

Current status of pulmonary thromboembolic disease: Pathophysiology, diagnosis, prevention, and treatment

Cited by 232 publications

References 123 publications

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

Fatal pulmonary embolism in hospitalized patients. Clinical diagnosis versus pathological confirmation

Long-Term Management of Patients After Venous Thromboembolism

Contact Info

Product

Resources

About