Clinical validity of a normal pulmonary angiogram in patients with suspected pulmonary embolism - A critical review
| Autor: | Edwin J. R. van Beek, Bin Song, Paul D. Stein, Matthijs Oudkerk, Elise M. J. Brouwers |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2001 |
| Předmět: |
medicine.medical_specialty
INTERMEDIATE PROBABILITY pulmonary embolism diagnosis DIGITAL SUBTRACTION ANGIOGRAPHY review HELICAL CT COST-EFFECTIVENESS ANALYSIS Pulmonary Artery Sensitivity and Specificity pulmonary angiography Recurrence Pulmonary angiography medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies VENTILATION-PERFUSION SCINTIGRAPHY Prospective cohort study VENOUS THROMBOEMBOLISM Lung medicine.diagnostic_test Vascular disease business.industry Respiratory disease Anticoagulants General Medicine Digital subtraction angiography medicine.disease Pulmonary embolism Surgery Radiography medicine.anatomical_structure Angiography SPIRAL CT ANGIOGRAPHY INTEROBSERVER AGREEMENT Radiology business FOLLOW-UP ANATOMIC DISTRIBUTION |
| Zdroj: | Clinical radiology, 56(10), 838-842. W B SAUNDERS CO LTD |
| ISSN: | 0009-9260 |
| DOI: | 10.1053/crad.2001.0778 |
| Popis: | AIM: To determine the validity of a normal pulmonary angiogram in the exclusion of pulmonary embolism (PE), based on the safety of withholding anticoagulant therapy in patients with a normal pulmonary angiogram. MATERIALS AND METHODS: A review of English reports published between 1965 and April 1999 was carried out. Eligible articles described prospective studies in patients with suspected PE and a normal pulmonary angiogram, who remained untreated and were followed-up for a minimum of 3 months. Articles were evaluated by two authors, using pre-defined criteria for strength of design. End points consisted of fatal and non-fatal recurrent thromboembolic events. A sensitivity analysis was performed, by removing one study at a time from the overall results and by comparing pre- and post-1990 publications. RESULTS: Among 1050 patients in eight articles included in the analysis, recurrent thromboembolic events were described in 18 patients (1.7% 95% CI: 1.0–2.7%). These were fatal in three patients (0.3% 95% CI: 0.02–0.7%). The recurrence rate of PE decreased from 2.9% (95% CI: 1.4–6.8%) before 1990 to 1.1% (95% CI: 0.5–2.2%) after 1990. CONCLUSION: It would appear that the ability to exclude PE by angiography has improved over the years, as indicated by recurrence rate of PE. The low recurrence rate of PE supports the validity of a normal pulmonary angiogram for the exclusion of PE. van Beek, E. J. R. et al . (2001). Clinical Radiology 56 , 838–842. |
| Databáze: | OpenAIRE |
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