Diagnosis and management of isolated subsegmental pulmonary embolism: review and assessment of the options. Clin Appl Thromb Hemost 2012;18(1):20-6
Date
09/29/2011Pubmed ID
21949040DOI
10.1177/1076029611422363Scopus ID
2-s2.0-84857526461 (requires institutional sign-in at Scopus site) 132 CitationsAbstract
We assessed the potential safety of withholding treatment of pulmonary embolism (PE) limited to subsegmental branches. Literature review showed that untreated patients with mostly subsegmental PE had no fatal recurrences in 1 to 3 months and no nonfatal recurrences of PE in 3 months. Patients with suspected PE who had nondiagnostic ventilation/perfusion lung scans, adequate cardiorespiratory reserve or low or moderate clinical probability, and negative serial noninvasive leg tests were shown not to require treatment. It appears safe, therefore, to withhold treatment of subsegmental PE providing (1) pulmonary-respiratory reserve is good; (2) no evidence of deep venous thrombosis (DVT) on serial testing; (3) major risk factor for PE was transient and no longer present; (4) no history of central venous catheterization or atrial fibrillation; and (5) willingness to return for serial venous ultrasound. After fully informing patients, some may choose to be treated and some may choose not to be treated.
Author List
Stein PD, Goodman LR, Hull RD, Dalen JE, Matta FAuthor
Lawrence Goodman MD Emeritus Professor in the Radiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
FemaleHumans
Male
Pulmonary Embolism
Recurrence
Risk Factors
Time Factors
