急性肺栓塞における肺血管撮影の合併症と有効性

P D Stein¹, C Athanasoulis, A Alavi

¹Henry Ford Heart and Vascular Institute, Detroit, Mich. 48202.

Circulation

|February 1, 1992

まとめ

肺血管撮影は合併症のリスクが低い (死亡率は0.5%,非致命的な重症は1%),診断有効性が高い (診断は96%),適切な臨床環境で肺栓塞 (PE) の診断に適しています.

科学分野:

心血管画像検査 (CVDI) について
診断放射線学診断放射線学

背景:

肺栓塞症診断の見通し調査 (PIOPED) は,以前,急性肺栓塞症 (PE) のための換気/輸液スキャンを評価していました.
この研究は,PIOPEDコホート内の肺血管撮影のリスクと診断精度に焦点を当てています.

研究の目的:

大規模な患者コホートにおける肺血管撮影の安全性と診断有効性を評価する.
PE診断のための肺血管撮影の合併症率と診断成功率を決定する.

主な方法:

PIOPED研究の一環として肺血管撮影を受けた1,111人の患者の分析.
死亡,重大非致死事件,腎機能不全を含む合併症率の評価.
アンジオグラムの診断収量と診断結果の評価.

主要な成果:

肺動脈動脈造影は低合併症率を示した:死亡率は0.5%,非致命的な合併症は1%であった.
合併症の発生率は,集中治療室の患者 (4%) と他の患者 (1%) に比べて高かった.
血管図は3%の症例で診断されず,腎機能不全は1%で,特に高齢の患者で発生しました.

結論:

肺血管撮影は,適切な臨床状況で肺栓塞の貴重な診断ツールとなるのに十分なリスクを伴います.
肺血管撮影を受ける前に患者のリスクを評価する際には,臨床的判断が最優先です.

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