Clinical characteristics of in-situ pulmonary artery thrombosis in Korea
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Published on: November 18, 2018
Seung-Ick Cha1, Keum-Ju Choi, Kyung-Min Shin
1aDepartment of Internal Medicine bDepartment of Radiology, Kyungpook National University School of Medicine, Daegu, South Korea.
Insights
Pulmonary artery thrombosis (PAT) often occurs in patients with tuberculosis-destroyed lung or after lung resection. Clots in PAT patients showed less resolution compared to pulmonary embolism, with no significant difference in outcomes with or without anticoagulation.
Area of Science:
- Cardiology
- Pulmonology
- Radiology
Background:
- Pulmonary artery thrombosis (PAT) is a poorly understood condition.
- Understanding its clinical features and course is crucial for patient management.
Purpose of the Study:
- To investigate the clinical characteristics of in-situ pulmonary artery thrombosis (PAT).
- To compare clinical parameters between PAT patients and a control group with pulmonary embolism.
Main Methods:
- Retrospective identification of 23 PAT patients from a South Korean tertiary referral center.
- Comparison with a control group of pulmonary embolism patients.
- Analysis of underlying conditions, clot location, and resolution rates via computed tomography scans.
Main Results:
- Tuberculosis-destroyed lung (47.8%) and pulmonary artery stump after lung resection (30.4%) were the most common underlying conditions in PAT patients.
- Clot resolution was significantly less frequent in the PAT group (25%) compared to the control group (90%).
- Anticoagulation therapy did not show a significant difference in improvement rates for PAT patients.
Conclusions:
- Tuberculosis-destroyed lung and post-lung resection pulmonary artery stump are key underlying conditions for PAT in South Korea.
- PAT clots, predominantly in the right or left pulmonary artery, exhibit lower resolution rates than typical pulmonary embolism.
- Further research is needed to establish optimal treatment strategies for PAT, as anticoagulation efficacy was not definitively proven in this study.
Abstract:
Little is known regarding the clinical features and course of in-situ pulmonary artery thrombosis (PAT). The aim of the present study was to investigate the clinical characteristics of PAT. Patients with PAT were retrospectively identified from a tertiary referral center in South Korea. A control group consisted of patients with pulmonary embolism in whom the right or left pulmonary artery was the largest pulmonary embolism-involved site. We compared various clinical parameters between the two groups. Of the 23 PAT patients, the most common underlying condition was tuberculosis-destroyed lung [11 (47.8%)], followed by pulmonary artery stump after lobectomy or pneumonectomy [7 (30.4%)]. In all patients except one, PAT was located in the right or left pulmonary artery. Computed tomography scans demonstrated that clots were completely or partially resolved less frequently in the PAT group than in the control group [4 (25%) versus 62 (90%); P < 0.001]. In the PAT group, three of the seven patients (43%) who had undergone anticoagulation therapy exhibited improvement, and one of the nine patients (11%) who had not received anticoagulation therapy experienced improvement; however, the difference was not significant. Tuberculosis-destroyed lung was the most common underlying condition in Korean PAT patients, followed by pulmonary artery stump after lung resection. The clots in patients with PAT were mostly located in the right or left pulmonary artery, and clot resolution was less frequent in the PAT group compared to the pulmonary embolism group.
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