Electron Beam Tomography of Interpulmonary Saddle Embolism: Extent and Vascular Distribution

Abstract

Interpulmonary saddle emboli appear to be a transient form of acute pulmonary embolism, the site of predilection for rupture of the embolus being the level of the bifurcation. Their frequency may therefore be underestimated.

The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

“…Radiological evidence of SE is found in approximately 2-5% of all patients with PE [7,8]. However, its true frequency may be underestimated because many patients are too unstable to undergo CT angiography (CTA), and the diagnosis is often established at autopsy.…”

Saddle pulmonary embolism: Is it as bad as it looks? A community hospital experience*

“…However, the true incidence is difficult to determine since many patients are too unstable to receive a CT angiogram (CTA) and the diagnosis is often established at autopsy. Some have proposed that SPE represents a transient form of acute PE, thus their true frequency may therefore be understimated (6). Saddle PE represents a large clot burden and is an important risk for right ventricular dysfunction and sudden hemodynamic collapse.…”

Cauda equina syndrome versus saddle embolism

“…A saddle embolism is characterised by an embolus that extends across the bifurcation of a vessel for example the main pulmonary artery, the distal aorta, or even a patent foramen ovale. 1 Serial studies have reported cardiac disease in 90% of patients with peripheral arterial embolism or saddle embolus, particularly ischaemic heart disease, valvular disorders or atrial fibrillation. 2 The cauda equina, and rarely the conus medullaris, are supplied by the lower lumbar, iliolumbar and lateral sacral arteries.…”