Pulmonary Embolism in Childhood: A Multicenter Experience from Turkey

Area of Science:

• Pediatric Medicine
• Cardiovascular Medicine
• Radiology

Background:

• Pulmonary embolism (PE) is a rare, life-threatening condition in children caused by pulmonary artery obstruction.
• Pediatric PE characteristics, risk factors, and outcomes remain largely unknown.
• This study investigates clinical features, risk factors, diagnostics, and treatment of pediatric PE.

Purpose of the Study:

• To evaluate clinical features of pediatric pulmonary embolism.
• To identify genetic and acquired risk factors for pediatric PE.
• To assess diagnostic imaging, treatment strategies, and long-term outcomes in children with PE.

Main Methods:

• Retrospective multicenter clinical trial involving 24 pediatric patients (0-18 years) diagnosed with PE via CTPA.
• Data collected on clinical features, risk factors (genetic/acquired), Wells scores, and in situ pulmonary artery thrombosis (ISPAT).
• Treatment response evaluated through follow-up CTPA, with outcomes categorized as complete recovery, incomplete recovery, or no response.

Main Results:

• All but one patient had at least one risk factor; Factor V Leiden mutation was most common (16.6%).
• Wells score sensitivity was 37.5%, indicating insufficiency for pediatric PE diagnosis.
• Complete recovery was observed in 62.5%, incomplete in 29.1%, and 8.3% died.

Conclusions:

• The Wells scoring system requires improvement for pediatric PE diagnosis.
• In situ pulmonary artery thrombosis (ISPAT) may be more prevalent in children with congenital heart disease and systemic diseases.