Correlation between the site of pulmonary embolism and the extent of deep vein thrombosis: evaluation by computed tomography pulmonary angiography and computed tomography venography

Horii, Yosuke; Yoshimura, Norihiko; Hori, Yoshiro; Takaki, Satoshi; Takano, Toru; Inagawa, Shoichi; Aoyama, Hidefumi

doi:10.1007/s11604-010-0533-y

Cited by 14 publications

(12 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We noted a greater proportion of right-sided DVTs among embolized clots, which is consistent with what has been previously reported in the literature for PEs that occur following right-sided versus leftsided DVT. 23,24 The presence of a free-floating tail for thrombi has been also associated in some, 25,26 but not all, 27 previous studies with higher risk of PE; a finding that was also reported in two of the cases in our study. However, the small number of cases found by this systematic review raises caution against firm conclusions.…”

Section: Discussionsupporting

confidence: 79%

Pulmonary Embolism As a Consequence of Ultrasonographic Examination of Extremities for Suspected Venous Thrombosis: A Systematic Review

Mehdipoor

Shabestari

Lip

et al. 2016

Semin Thromb Hemost

View full text Add to dashboard Cite

Ultrasonographic examination for deep vein thrombosis (DVT) appears to be a safe diagnostic method, but a theoretical concern has been raised for dislodgment of thrombi during examination. We conducted a systematic review of the literature to identify reports of possible or confirmed pulmonary embolism (PE) as a consequence of ultrasonographic assessment of extremities in patients with suspected DVT. We searched PubMed for studies published in English from January 1, 1960, to April 10, 2015. We included all cohort studies, case series, and case reports that described PE as a consequence of ultrasonographic assessment of extremities. We excluded studies that reported assessment of areas other than extremities. We screened 3,626 articles, 15 of which reported the issue of clot dislodgement and embolization following ultrasonographic examination of the extremities, including 8 original case reports (7 men and 1 woman). DVTs were in the lower extremities in all eight cases: five in right and three in left lower extremity. In six cases, the femoral veins were involved, and a free-floating thrombus was reported in two cases. Compression ultrasonography was used in all cases, with or without adjunct techniques. Overall, there were seven confirmed and one probable PE cases, two of which had fatal outcomes. Clot embolization is a rare but potential complication of ultrasonic examination for DVT that can lead into PE. Radiologists and clinicians should be aware of this potentially serious phenomenon and avoid excessive pressure when performing ultrasonographic studies of the extremities.

show abstract

Section: Discussionsupporting

confidence: 79%

Pulmonary Embolism As a Consequence of Ultrasonographic Examination of Extremities for Suspected Venous Thrombosis: A Systematic Review

Mehdipoor

Shabestari

Lip

et al. 2016

Semin Thromb Hemost

View full text Add to dashboard Cite

show abstract

“…Horii et al15) suggested the use of anticoagulants for proximal DVT and PTE because PTEs were less correlated with distal DVTs in the study. However, prophylactic anticoagulation therapy does not necessarily result in good clinical results.…”

Section: Discussionmentioning

confidence: 78%

“…Anticoagulation therapy was performed in 25 cases, in 17 PTE and 8 proximal DVT15). Of these, 20 cases were available for a second MDCT-indirect venography, which showed complete resolution in 16 cases (80%), ≥50% resolution in 3 cases (15%), and PTE resolution but occurrence of distal DVT in 1 case (5%).…”

Section: Resultsmentioning

confidence: 99%

Incidence of Venous Thromboembolism Using 64 Channel Multidetector Row Computed Tomography-Indirect Venography and Anti-Coagulation Therapy after Total Knee Arthroplasty in Korea

Park

Cheon

Lee

et al. 2012

Knee Surg Relat Res

View full text Add to dashboard Cite

PurposeThis study evaluated the incidence of a venous thromboembolism (VTE) after total knee arthroplasty (TKA) using multidetector row computed tomography-indirect venography (MDCT-indirect venography) and assessed the efficacy of anti-coagulation therapy.Materials and MethodsWe enrolled 118 patients with 126 cases of TKA. The average age of the patients was 68.4 years. We used 64 channel MDCT-indirect venography for the detection of VTE. We treated selectively proximal deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE) cases according to the results of MDCT-indirect venography. We re-evaluated the change in VTE using follow-up MDCT-indirect venography after 3 months.ResultsWe identified VTE in 35.7%. DVT only was identified in 22.2% including 8 cases of proximal DVT and 20 cases of distal DVT. PTE without DVT was identified in 4.8%, and combined DVT and PTE in 8.7%. All patients with PTE were asymptomatic, but 4 DVT patients had signs of leg swelling. After anti-coagulation therapy, 20 patients showed complete resolution in 16 cases, improvement in 3 cases and one case showed a new distal DVT.ConclusionsThe incidence of VTE after primary TKA was 35.7% in Korea. Furthermore, anti-coagulation therapy for proximal DVT and PTE patients may be a useful method for preventing the occurrence of a fatal PTE.

show abstract

“…On the one hand, CTV, which is invasive, has a smaller anatomical blind spot than US, and thus, it can more extensively evaluate venous problems. [ 17 ] However, CTV should be performed in appropriate patients because it is costly and carries a risk of contrast media reaction and post procedural phlebitis. In previous studies, estimates of severe reactions to contrast media such as pulmonary edema, cardiac arrhythmias, and cardiac arrest range from 0.04% to 0.2%.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of computed tomography venography in gynecologic cancer patients with lower extremity edema

Kim

Kim²,

Kang³

et al. 2020

Medicine

View full text Add to dashboard Cite

Lower extremity (LEx) edema is a common complication in gynecologic cancer patients. There are 2 main causes of edema in these patients such as deep vein thrombosis (DVT) and lymphedema. Early diagnosis and treatment of DVT are certainly important, but it is often difficult to evaluate proximal DVT by using ultrasound. The aim of this study is to demonstrate the usefulness of computed tomography venography of the lower extremity (CTV LEx) for the diagnosis of the DVT and investigate predictive factor of DVT in gynecologic cancer patients with LEx edema. The medical records of 415 gynecologic cancer patients who were referred to the department of rehabilitation medicine with LEx edema were retrospectively reviewed in this case-controlled study. We categorized CTV LEx findings as follows: DVT proximal to the inguinal ligament (inferior vena cava or iliac vein thrombosis) and DVT distal to the inguinal ligament (femoral, popliteal, or calf vein thrombosis). We also evaluated patient characteristics including d -dimer level. We analyzed the correlation of each factor with DVT frequency and used receiver operating characteristic curve analysis to determine the appropriate d -dimer threshold. Sixty-six patients were diagnosed with DVT; of them, 35 (53%) had DVT proximal to the inguinal ligament. Twenty-two patients were diagnosed with pulmonary embolism, of whom 15 had proximal DVT. Patients with proximal DVT tended to have pulmonary embolism ( P < .001). Distal organ metastasis (odds ratio [OR], 2.88; P = .002) and a high D-dimer level (OR, 1.13; P = .001) were correlated with DVT. CTV LEx is a useful diagnostic tool for gynecologic cancer patients with LEx edema, particularly high-risk patients, that should be performed at the initial evaluation.

show abstract

Correlation between the site of pulmonary embolism and the extent of deep vein thrombosis: evaluation by computed tomography pulmonary angiography and computed tomography venography

Abstract: Proximal PEs were correlated with proximal DVTs. Patients with a proximal DVT tended to have a PE, especially with a right-proximal DVT. Hence, the presence of a right-proximal DVT has the potential for serious complications, and carefully diagnosis is required for PE and DVT.

Cited by 14 publications

References 23 publications

Pulmonary Embolism As a Consequence of Ultrasonographic Examination of Extremities for Suspected Venous Thrombosis: A Systematic Review

Pulmonary Embolism As a Consequence of Ultrasonographic Examination of Extremities for Suspected Venous Thrombosis: A Systematic Review

Incidence of Venous Thromboembolism Using 64 Channel Multidetector Row Computed Tomography-Indirect Venography and Anti-Coagulation Therapy after Total Knee Arthroplasty in Korea

Usefulness of computed tomography venography in gynecologic cancer patients with lower extremity edema

Contact Info

Product

Resources

About