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07:44
A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
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Diagnostic outcome management study in patients with clinically suspected recurrent acute pulmonary embolism with a
Inge C M Mos1, Renée A Douma2, Petra M G Erkens3
1Department of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands.
Thrombosis Research
|April 17, 2014
Summary
A diagnostic strategy using Wells rule, D-dimer, and CTPA safely manages suspected recurrent pulmonary embolism (PE). This approach effectively rules out PE in most patients, with a low risk of fatal events during follow-up.
Area of Science:
- Medical Diagnostics
- Cardiology
- Pulmonary Medicine
Background:
- Diagnostic strategies for recurrent pulmonary embolism (PE) require validation.
- Establishing the safety and efficacy of diagnostic algorithms is crucial for clinical practice.
Purpose of the Study:
- To evaluate a diagnostic strategy for acute recurrent PE.
- To determine the safety of using Wells clinical decision rule (CDR), D-dimer testing, and CTPA.
Main Methods:
- A multicenter clinical outcome study involving 516 patients with suspected acute recurrent PE.
- Patients were not on anticoagulants during the study period.
Main Results:
- The diagnostic algorithm was feasible in 98% of patients.
- Recurrent PE was excluded in 17% of patients using unlikely CDR and normal D-dimer, with no VTE events.
- CTPA confirmed PE in 33% and excluded it in 49% of patients, with a low rate of fatal PE during follow-up.
Conclusions:
- A diagnostic algorithm combining CDR, D-dimer, and CTPA is effective for suspected acute recurrent PE.
- CTPA is safe for excluding PE in patients with likely clinical probability or elevated D-dimer, showing a low risk of fatal PE.
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