Pulmonary Embolism With Clot in Transit: An Analysis of Risk Factors and Outcomes

Abstract

me to develop the critical thinking skills and vision necessary to be successful in academia and clinically. His mentorship and direction have been invaluable, and I will carry these experiences with me throughout my career.I would also like to thank Dr. Hui Zheng for his assistance with statistical analysis.He truly helped this project come to fruition, and I sincerely appreciate all of his hard work.Additionally, I would like to thank the members of the Center for Vascular Emergencies at Massachusetts General Hospital. In particular, I would like to thank Nicholas Giordano, who has been a tremendous source of support throughout my project.He has always been available with a helping hand, and I appreciate him taking his time to assist me throughout this project. I would also like to thank my fellow clinical research coordinator, Jasmine Torrey, who oriented me to our Pulmonary Embolism Response Team database and has been a friend throughout this year.Lastly, I would like to thank the students and faculty of the Boston University M.S.in Medical Sciences Program. Thank you to Dr. Carl Franzblau who has been a wonderful advisor throughout my time in this program and provided feedback on this thesis. I would also like to thank our program director, Dr. Gwynneth Offner. She put her faith in me and truly changed the trajectory of my life. I hope to make her proud as a future physician. vi

Acute Pulmonary Embolism at Tanta University Hospital: Single Centre Registry

“…The mean age of our patients was 51.92 ± 14.74, the relatively younger age of our patients confirmed when compared with the RIETE [5] registry which is a multicenter registry that was conducted on 23,858 patients in which the mean age was 67.3 ±17.0. Also the mean age of our patients was less than that in the study made by Garvey S et al [6], that was conducted on 1121 patients in which the mean age was 60.1 ± 16.7, also in the study made by Jiménez D et al, [7] that was conducted on 2096 patients the mean age was 68.7±16.6.…”

“…In contrast the percentage of males was higher in the study made by Garvey S et al [6] 52% males and 48% females.…”

A clinical decision framework to guide the outpatient treatment of emergency department patients diagnosed with acute pulmonary embolism or deep vein thrombosis: Results from a multidisciplinary consensus panel

“…If CTPA demonstrates right ventricular dilatation, echocardiography may be indicated. Echocardiography is also better suited to evaluate clot in transit, another high‐risk imaging feature 55–58 . High‐risk laboratory values include an elevated troponin 59,60 .…”

Risk Stratification in Acute Pulmonary Embolism: The Latest Algorithms

“…However, this may be an overestimate due to selection bias, as an almost equal number of patients with less severe PE did not undergo echocardiography in the same cohort. 101 RHT can originate from the lower extremities, known as "thrombus in transit," 102 or can form in situ in the right atrium in patients with comorbid atrial fibrillation. 103 History of heart failure, preexisting central venous catheter, and hypotension were all associated with increased incidence of clot in transit.…”

“…103 History of heart failure, preexisting central venous catheter, and hypotension were all associated with increased incidence of clot in transit. 102 It is estimated that thrombus in situ complicates 2% of inpatients hospitalized with PH and atrial fibrillation. 103 A meta-analysis showed that RHT is associated with increased all-cause and PE-related mortality.…”