How do vena caval filters as an adjunct to anticoagulation therapy compare with anticoagulation therapy alone for adults with unprovoked symptomatic pulmonary embolism at high risk for recurrence?

2021 ◽  
Author(s):  
Deepak Vedamurthy
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Anticoagulation Therapy ◽  
Symptomatic Pulmonary Embolism

Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism

CHEST Journal ◽  
2015 ◽  
Vol 148 (1) ◽  
pp. 211-218 ◽  
Author(s):  
Carolina Fernández ◽  
Carlo Bova ◽  
Olivier Sanchez ◽  
Paolo Prandoni ◽  
Mareike Lankeit ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Symptomatic Pulmonary Embolism

scholarly journals Combinations of prognostic tools for identification of high-risk normotensive patients with acute symptomatic pulmonary embolism

Thorax ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. 75-81 ◽  
Author(s):  
D. Jimenez ◽  
D. Aujesky ◽  
L. Moores ◽  
V. Gomez ◽  
D. Marti ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Symptomatic Pulmonary Embolism

Limited Usefulness of Tests of Coagulation Defects for Predicting Symptomatic Pulmonary Embolism after an Initial Episode of Deep Vein Thrombosis

2000 ◽  
Vol 15 (2) ◽  
pp. 75-80
Author(s):  
H. Yasuhara ◽  
T. Muto
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Cox Regression ◽  
Anticoagulation Therapy ◽  
Anticardiolipin Antibody ◽  
Vein Thrombosis ◽  
Symptomatic Pulmonary Embolism ◽  
Coagulation Defects ◽  
Deep Vein ◽  
Limited Usefulness

Objective: To establish the usefulness of currently available tests of coagulation defects for predicting symptomatic pulmonary embolism (PE) in patients with lower extremity deep vein thrombosis (DVT). Methods: Between 1980 and 1996, 294 patients with DVT were followed for a mean period of 7.9 years. The coagulation defects included low activity of antithrom-bin III, protein C, protein S or plasminogen, and positivity for lupus anticoagulant or anticardiolipin antibody. The influences of these coagulation abnorm-alities on PE incidence were analysed, using a Cox regression hazards model. Results: Coagulation defects were found to be an important variable predicting PE (risk ratio = 7.272). ‘PE-free survival’ in patients with no coagulation defect was significantly longer than that in patients with one or more of these defects ( p = 0.0001). The sensitivity of coagulation tests for predicting PE was only 47% despite the negative predictive value of 93%. Conclusions: Determining these defects has limited usefulness in identifying patients who would be appropriate candidates for intensive anticoagulation therapy.

scholarly journals Venous thromboembolism in patients with adrenocortical carcinoma after surgery

2020 ◽  
Vol 9 (9) ◽  
pp. 874-881
Author(s):  
Jülide Durmuşoğlu ◽  
Henri J L M Timmers ◽  
Pepijn van Houten ◽  
Hans F Langenhuijsen ◽  
Ad R M M Hermus ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
High Risk ◽  
Adrenocortical Carcinoma ◽  
Pulmonary Metastases ◽  
Low Molecular Weight ◽  
Symptomatic Pulmonary Embolism ◽  
Pulmonary Embolisms ◽  
Rare Malignancy

Background: Adrenocortical carcinoma is a rare malignancy with a poor prognosis. We hypothesized that patients with adrenocortical carcinoma are at high risk for venous thromboembolism, given the numerous risk factors such as malignancy, abdominal surgery, immobility and hormonal excess. The aim of this study was to determine retrospectively the incidence of venous thromboembolisms after surgical treatment in patients with adrenocortical carcinoma. Materials and methods: A retrospective study was performed, collecting data from all patients diagnosed with adrenocortical carcinoma from 2003 to 2018 at the Radboud University Medical Centre, The Netherlands. Results: In 34 patients, eight postoperative venous thromboembolisms, all pulmonary embolisms, were diagnosed in the first 6 months after adrenalectomy (23.5%). In addition, one patient developed pulmonary embolism just prior to surgery and one patient 7 years after surgery. Five of the eight patients with postoperative venous thromboembolisms presented with symptomatic pulmonary embolism whereas the other three pulmonary embolisms were incidentally found on regular follow up CT scans. Seven of the eight venous thromboembolisms occurred within 10 weeks after surgery. Seven of the eight patients had advanced stage adrenocortical carcinoma and four patients already received low-molecular weight heparin during the development of the venous thromboembolism. There was one case of fatal pulmonary embolism in a patient with a cortisol producing tumor with pulmonary metastases, despite the use of a therapeutic dose thromboprophylaxis. Conclusion: Patients with adrenocortical carcinoma are at high risk of developing postoperative venous thromboembolisms. Prolonged postoperative thromboprophylaxis could be considered in these patients.

COVID-19 complicated by pulmonary embolism treated with catheter directed thrombectomy

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 333-337 ◽  
Author(s):  
Francisco Leonardo Galastri ◽  
Leonardo Guedes Moreira Valle ◽  
Breno Boueri Affonso ◽  
Marcela Juliano Silva ◽  
Rodrigo Gobbo Garcia ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Dynamic Process ◽  
Therapeutic Option ◽  
Massive Pulmonary Embolism ◽  
Percutaneous Intervention ◽  
Thromboembolic Events ◽  
Emergency Center ◽  
Catheter Directed Thrombolysis

Summary: COVID-19 is a recently identified illness that is associated with thromboembolic events. We report a case of pulmonary embolism in a patient with COVID-19, treated by catheter directed thrombectomy. A 57 year old patient presented to the emergency center with severe COVID-19 symptoms and developed massive pulmonary embolism. The patient was treated with catheter directed thrombolysis (CDT) and recovered completely. Coagulopathy associated with COVID-19 is present in all severe cases and is a dynamic process. We describe a case of massive/high risk pulmonary embolism, in a patient with COVID-19 receiving full anticoagulation, who was treated by percutaneous intervention. CDT can be an additional therapeutic option in patients with COVID-19 and pulmonary embolism that present with rapid clinical collapse.

The Role of a Decision Rule in Symptomatic Pulmonary Embolism Patients with a Non-high Probability Ventilation-perfusion Scan

1997 ◽  
Vol 78 (02) ◽  
pp. 794-798 ◽  
Author(s):  
Bowine C Michel ◽  
Philomeen M M Kuijer ◽  
Joseph McDonnell ◽  
Edwin J R van Beek ◽  
Frans F H Rutten ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Decision Rule ◽  
Predictive Value ◽  
Patient Population ◽  
High Probability ◽  
Characteristic Curve ◽  
Stepwise Logistic Regression ◽  
Pulmonary Angiogram ◽  
Symptomatic Pulmonary Embolism ◽  
Perfusion Scan

Summary Background: In order to improve the use of information contained in the medical history and physical examination in patients with suspected pulmonary embolism and a non-high probability ventilation-perfusion scan, we assessed whether a simple, quantitative decision rule could be derived for the diagnosis or exclusion of pulmonary embolism. Methods: In 140 consecutive symptomatic patients with a non- high probability ventilation-perfusion scan and an interpretable pulmonary angiogram, various clinical and lung scan items were collected prospectively and analyzed by multivariate stepwise logistic regression analysis to identify the most informative combination of items. Results: The prevalence of proven pulmonary embolism in the patient population was 27.1%. A decision rule containing the presence of wheezing, previous deep venous thrombosis, recently developed or worsened cough, body temperature above 37° C and multiple defects on the perfusion scan was constructed. For the rule the area under the Receiver Operating Characteristic curve was larger than that of the prior probability of pulmonary embolism as assessed by the physician at presentation (0.76 versus 0.59; p = 0.0097). At the cut-off point with the maximal positive predictive value 2% of the patients scored positive, at the cut-off point with the maximal negative predictive value pulmonary embolism could be excluded in 16% of the patients. Conclusions: We derived a simple decision rule containing 5 easily interpretable variables for the patient population specified. The optimal use of the rule appears to be in the exclusion of pulmonary embolism. Prospective validation of this rule is indicated to confirm its clinical utility.

Sex as a prognostic factor for mortality in adults with acute symptomatic pulmonary embolism

2021 ◽  
Author(s):  
Jesús López-Alcalde ◽  
Elena C Stallings ◽  
Javier Zamora ◽  
Alfonso Muriel ◽  
Sander van Doorn ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Prognostic Factor ◽  
Symptomatic Pulmonary Embolism

scholarly journals Acute pulmonary embolism in COVID-19 patient: a case report of free-floating right heart thrombus successfully treated with fibrinolysis

2020 ◽  
Author(s):  
Fernando Scudiero ◽  
Antonino Pitì ◽  
Roberto Keim ◽  
Guido Parodi
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Retrospective Studies ◽  
Right Heart ◽  
Clinical Issue ◽  
Systemic Thrombolysis ◽  
Case Summary ◽  
High Prevalence ◽  
Life Threatening ◽  
Complex Scenario

Abstract Background Despite the fast-growing understanding of the coronavirus disease 2019 (COVID-19), patient management remains largely empirical or based on retrospective studies. In this complex scenario, an important clinical issue appears to be represented by the high prevalence of thromboembolic events, but the data regarding high-risk pulmonary embolism (PE) is still not available. Case summary A patient with COVID-19 developed sudden shortness of breath and hypoxia. Early echocardiographic diagnosis of high-risk PE related to right heart thrombus was performed. Systemic thrombolysis was administered with excellent clinical and haemodynamic response. Discussion Pulmonary thromboembolism is a common occurrence in severe COVID-19 infection. In our experience, systemic thrombolysis proved to be effective and for this reason may be considered for life-threatening PE in COVID-19 patients.

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