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A Porcine Model of Acute Autologous Pulmonary Embolism
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[Should we treat subsegmental pulmonary embolism?].
1Service d'Angiologie et d'Hémostase, Hôpitaux Universitaires de Genève, 4 rue Gabrielle-Perret-Gentil, 1211 Genève 14, Suisse.
Journal Des Maladies Vasculaires
|December 20, 2011
Summary
Subsegmental pulmonary embolisms (PE) are increasingly diagnosed but their clinical impact is unclear. Anticoagulation benefits may not outweigh bleeding risks for these smaller PEs.
Area of Science:
- Radiology and Imaging
- Cardiovascular Medicine
- Pulmonary Medicine
Context:
- Multi-detector computed tomography (MDCT) has increased subsegmental pulmonary embolism (PE) diagnoses.
- Clinical significance and prognosis of subsegmental PE remain largely unknown.
- Established diagnostic strategies struggle to detect subsegmental PE.
Purpose:
- To evaluate the clinical significance and prognosis of subsegmental pulmonary embolism.
- To assess the benefit of anticoagulation for subsegmental PE.
- To compare diagnostic strategies using single-detector vs. multi-detector computed tomography.
Summary:
- Subsegmental PEs are increasingly detected by MDCT, but their clinical impact is uncertain.
- Diagnostic strategies validated for larger PEs often miss subsegmental embolisms.
- Anticoagulation for subsegmental PE may pose bleeding risks exceeding recurrent event prevention benefits.
Impact:
- Subsegmental PEs appear to have a less severe clinical impact and better prognosis than proximal PEs.
- Current diagnostic approaches may lead to overdiagnosis and unnecessary anticoagulation.
- Risk-benefit assessment of anticoagulation is crucial for patients with isolated subsegmental PE.
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