Massive pulmonary embolism: a comparison of radiological and clinical characteristics and outcomes

Schneider, Roslyn F.; Ntimba, Francis; Hourizadeh, Aman; Schwartz, Jonathan B.; Eber, Corey; Patnana, Madhavi; Goldfarb, Richard

doi:10.1007/s10140-002-0198-7

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…The size and amount of a pulmonary artery thrombus is not an independent predictor of mortality in PE patients. [17][18][19] However, Matej 20) reported that the morphology of an immobile central pulmonary thromboemboli in a massive PE is an independent predictor of short term mortality. Although the thrombus burden is not associated with the clinical severity of PE, patients with collapsed massive PE appear to have extensive pulmonary artery thrombus.…”

Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

et al. 2012

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SummaryWhen pulmonary embolism (PE) develops, circulatory collapse and hypoxia are caused at the same time. The rapid and proper use of extracorporeal life support (ECLS) can improve the mortality rate of patients with collapsed massive PE. No study has examined the influence of treatment that involved adding catheter based-intervention to ECLS with massive collapsed PE. Thirty-five patients with massive PE were examined, and 10 of these patients were placed on ECLS. Eight of the 10 patients placed on ECLS for massive PE were female, and the median age was 61 years. Seven patients had in-hospital onset PE and 3 patients out-of-hospital onset PE. Their underlying conditions were a cerebral infarction (3 patients), coronary artery disease (5 patients), collagen disease (one patient), postoperative state (3 patients), and lung disease (2 patients). Pulmonary angiographic findings showed that a filling defect or complete occlusion was observed in all 10 patients in the proximal lobular arteries, 6 of which had large thrombi stretching to the main pulmonary arteries. All patients underwent thrombolysis. Percutaneous catheter embolus fragmentation and/or thrombectomy were undertaken in 7 patients. All patients required red blood cell transfusion for cannulation site bleeding. The mean duration of ECLS bypass was 48 ± 44 hours. The 30 day mortality rate was 30%. The current study clarified the characteristics of patients with massive PE requiring ECLS. These patients have extensive pulmonary thromboemboli, thus, the aggressive use of catheter-based intervention appears to have beneficial effects for massive PE requiring ECLS. (Int Heart J 2012; 53: 370-374)

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Section: Discussionmentioning

confidence: 99%

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

et al. 2012

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“…In the present study, only 2 of the evaluated dogs were hypercapnic, indicating that alveolar hypoventilation was not a common problem. In studies [23][24][25] of pulmonary thromboembolism in dogs and humans, high Pao 2 -Pao 2 was more common than was hypoxemia, suggesting that calculation of this variable results in improved detection of abnormalities in gas exchange. Calculation of the Pao 2 -Pao 2 is also useful because it can be used to follow response to treatment, although this was not performed in the study of this report.…”

Section: Discussionmentioning

confidence: 99%

Clinical, clinicopathologic, and radiographic findings in dogs with aspiration pneumonia: 88 cases (2004–2006)

Kogan¹,

Johnson²,

Jandrey³

et al. 2008

javma

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Correlation of right ventricular dysfunction parameters and pulmonary vascular obstruction score in acute pulmonary embolism in a porcine model

et al. 2010

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This paper aims to non-invasively determine right ventricular dysfunction parameters (RVDP) in acute pulmonary embolism (APE) and to correlate these parameters with a computed tomography (CT)-based pulmonary artery obstruction score (OS). In seven domestic pigs, magnetic resonance imaging (MRI) was performed before (n = 7) and after (n = 5) APE was induced. Analysis of relative changes in right ventricular stroke volume (RVSV%), output (RVO%), end-systolic (RVESV%), end-diastolic volume (RVEDV%), and heart rate (HR%) was performed. Additionally, for the determination of the OS, all animals underwent contrast-enhanced CT-pulmonary angiography. The CT-based OS correlated strongly with RVSV% (r = 0.9576; p = 0.0104) and RVO% (r = 0.9703; p = 0.0061). Contrarily, almost no correlation could be demonstrated for the OS and the increase of RVESV % (r = 0.3850; p = 0.5222), RVEDV% (r = 0.1830; p = 0.7683), and HR% (r = 0.5494; p = 0.3375). The results of this experimental study underline that the CT-based OS correlates with RVDP as determined by cardiac MRI and might be a helpful tool for the severity assessment in APE.

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Massive pulmonary embolism: a comparison of radiological and clinical characteristics and outcomes

Abstract: Patients with MPE usually present with dyspnea and hypoxemia, and most survive without thrombolytic therapy.

Cited by 7 publications

References 13 publications

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

Massive Pulmonary Embolism Requiring Extracorporeal Life Support Treated With Catheter-Based Interventions

Clinical, clinicopathologic, and radiographic findings in dogs with aspiration pneumonia: 88 cases (2004–2006)

Correlation of right ventricular dysfunction parameters and pulmonary vascular obstruction score in acute pulmonary embolism in a porcine model

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