Non-traumatic thoracic emergencies: CT venography in an integrated diagnostic strategy of acute pulmonary embolism and venous thrombosis

Ghaye, Benoît; Dondelinger, Robert

doi:10.1007/s00330-002-1505-0

Cited by 46 publications

(30 citation statements)

References 62 publications

(125 reference statements)

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“…CT venography, coupled with CTPA without requiring additional CM injection, provides similar results to US for the diagnosis of DVT in femoro-popliteal veins [71]. The incremental value of adding CT venography to SD-CTPAwas reported in the range of 8-27% [71,73].…”

Section: Indirect Ct Venographymentioning

confidence: 88%

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When to perform CTA in patients suspected of PE?

Ghaye¹,

Dondelinger²

2007

Eur Radiol

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Venous thromboembolic disease (VTE) is a common disorder which may be associated with high morbidity or mortality when left untreated. Specific VTE diagnosis is mandatory, as treatment is associated with significant side effects. Therefore, timely diagnostic tests are necessary to establish the presence or absence of VTE. Computed tomographic pulmonary angiography (CTPA) has reached a high accuracy in the evaluation of pulmonary embolism (PE). Unfortunately, the continuous decrease of the prevalence of PE in the most recent studies can lead to cost-efficacy imbalance and overuse of ionizing radiation when CTPA is used as a single test. Therefore, no single non-invasive test is suitable for all patients and diagnostic strategies based on sequential non-invasive tests are likely to identify patients in whom anticoagulation can be withheld safely and limit the number of patients requiring more invasive or more expensive tests. The cost effectiveness of clinical stratification and D-dimer test has been demonstrated as it reduces the requirement for invasive tests. In this paper, the current role of CTPA in the diagnosis of PE will be reviewed.

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Section: Indirect Ct Venographymentioning

confidence: 88%

“…The incremental value of adding CT venography to SD-CTPAwas reported in the range of 8-27% [71,73]. A recent study showed that the incremental value of CT venography is not reduced when using MD-CTPA [73].…”

Section: Indirect Ct Venographymentioning

confidence: 98%

When to perform CTA in patients suspected of PE?

Ghaye¹,

Dondelinger²

2007

Eur Radiol

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“…Floating thrombosis is identified by partial loss of blood flow and migration of clots [7,8]. Contrast-enhanced CT can simultaneously evaluate the pulmonary arteries and abdominal /lower limb veins and is often performed when pulmonary thromboembolism is suspeceted [9]. In the present patient, ultrasonography and contrastenhanced CT demonstrated DVT extending to the iliac vein with a stable proximal end to the clot.…”

Section: Discussionmentioning

confidence: 66%

Gastrointestinal Bleeding During Anticoagulant Therapy for Deep Vein Thrombosis after Simultaneous Pancreas and Kidney Transplantation

Sannomiya¹,

Nakajima²,

Ogawa³

et al. 2017

J Clin Case Rep

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A 46-year-old Japanese woman on dialysis for type 1 diabetes and chronic renal failure underwent simultaneous pancreas and kidney transplantation from a brain-dead donor. On postoperative day 3, ilio-femoral deep vein thrombosis on the side of pancreatic transplantation was diagnosed from swelling of the right leg, an increased D-dimer level, and imaging findings. Anticoagulant therapy was initiated to prevent proximal propagation of the thrombosis and pulmonary thromboembolism. However, gastrointestinal bleeding occurred, which was thought to be due to mucosal bleeding from the duodenal graft. Her anticoagulant therapy was adjusted and hemostasis was conducted, controlling the gastrointestinal bleeding without surgical intervention. Blood flow was maintained to both grafts and graft function was good. When gastrointestinal bleeding occurs during anticoagulant therapy for deep vein thrombosis after combined pancreas and kidney transplantation, bleeding can be controlled by adjusting anticoagulant therapy and other appropriate measures.

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“…This is particularly true if CT venography is performed routinely with CT of the pulmonary arteries. The CT venography should therefore only be performed in addition to CT of the pulmonary arteries if this is positive for PE and demonstration of the extent and localization of deep venous thrombosis has an immediate impact on clinical management of the patient [10].…”

Section: Sirmentioning

confidence: 99%

Radiation dose in helical CT for detection of pulmonary embolism

Diederich

2003

Eur Radiol

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Non-traumatic thoracic emergencies: CT venography in an integrated diagnostic strategy of acute pulmonary embolism and venous thrombosis

Cited by 46 publications

References 62 publications

When to perform CTA in patients suspected of PE?

When to perform CTA in patients suspected of PE?

Gastrointestinal Bleeding During Anticoagulant Therapy for Deep Vein Thrombosis after Simultaneous Pancreas and Kidney Transplantation

Radiation dose in helical CT for detection of pulmonary embolism

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