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Titolo:
Clinically suspected pulmonary embolism: is it safe to withhold anticoagulation after a negative spiral CT?
Autore:
Gottsater, A; Berg, A; Centergard, J; Frennby, B; Nirhov, N; Nyman, U;
Indirizzi:
Univ Lund, Malmo Univ Hosp, Dept Vasc & Renal Dis, S-20502 Malmo, Sweden Univ Lund Malmo Sweden S-20502 t Vasc & Renal Dis, S-20502 Malmo, Sweden Univ Lund, Malmo Univ Hosp, Dept Diagnost Radiol, S-20502 Malmo, Sweden Univ Lund Malmo Sweden S-20502 pt Diagnost Radiol, S-20502 Malmo, Sweden
Titolo Testata:
EUROPEAN RADIOLOGY
fascicolo: 1, volume: 11, anno: 2001,
pagine: 65 - 72
SICI:
0938-7994(2001)11:1<65:CSPEII>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERFUSION LUNG-SCAN; COST-EFFECTIVENESS ANALYSIS; HELICAL CT; LOW-PROBABILITY; INTERMEDIATE-PROBABILITY; ANATOMIC DISTRIBUTION; ANGIOGRAPHY; DIAGNOSIS; SCINTIGRAPHY; VALIDITY;
Keywords:
pulmonary embolism; CT; pulmonary arteriography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
62
Recensione:
Indirizzi per estratti:
Indirizzo: Gottsater, A Univ Lund, Malmo Univ Hosp, Dept Vasc & Renal Dis, S-20502 Malmo, Sweden Univ Lund Malmo Sweden S-20502 l Dis, S-20502 Malmo, Sweden
Citazione:
A. Gottsater et al., "Clinically suspected pulmonary embolism: is it safe to withhold anticoagulation after a negative spiral CT?", EUR RADIOL, 11(1), 2001, pp. 65-72

Abstract

The goal of this study was 3-month clinical outcome in nonanticoagulated patients with clinically suspected acute pulmonary embolism (PE) following anegative spiral CT. During a 6-month period 305 patients underwent spiral CT, of whom only 8 also had a lung scintigraphy. In patients with a final CT report read as not positive for acute PE, all hospital records and answers to a patient questionnaire were analyzed for episodes of venous thrombembolism (VTE). Acute PE was diagnosed at spiral CT in 61 patients (20 %). Twenty-six of the remaining 244 patients were excluded from further analysis because of (a) longterm anticoagulation due to symptomatic acute deep venousthrombosis (n = 5), clinically diagnosed acute PE (n = 2), chronic recurrent VTE (n = 4), and cardiac disorders (n = 5); and (b) a normal perfusion scintigram (n = 4) or a negative pulmonary arteriogram (n = 6). Three patients were lost to follow-up. Among the remaining 215 patients only 10 had undergone a negative lower extremity venous study. Sixteen patients (7 %) diedduring the follow-up period, 6 of whom underwent autopsy. Venous thrombembolism was diagnosed in three of the 215 patients (1.4%, 95 % confidence limits: 0.5-4.0 %), one causing the patient's death. Two patients had advancedthoracic malignancies and the third severe chronic obstructive pulmonary disease (84 years old). A negative spiral CT may be able to exclude clinically significant acute PE with the same accuracy as a normal lung scintigraphy or a negative pulmonary arteriography.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/21 alle ore 03:00:10