A case series of outcomes in isolated subsegmental pulmonary embolism on ventilation-perfusion imaging

Nuclear Medicine Communications
Amy MallorieThomas Wagner

Abstract

The risk of recurrent venous thromboembolic disease and the management of patients with isolated subsegmental pulmonary embolism (SSPE) remain unclear. We sought to assess the long-term clinical outcome of patients with isolated SSPE demonstrated by isolated subsegmental mismatch found on ventilation/perfusion (V/Q) scans. We performed a retrospective observational study of 1300 consecutive patients with suspected pulmonary embolism who underwent index V/Q single-photon emission computed tomography between 2012 and 2013. Forty (3%) patients were found to have isolated SSPE identified on V/Q scan. Of the 40 patients with isolated SSPE on V/Q scan, 19 underwent further investigation with computed tomography pulmonary angiogram (CTPA) within 48 h. Among 19 patients who had corroborating CTPA performed concurrently, 94.7% of the SSPEs identified on V/Q were not detectable on CTPA. Of the 40 patients, 10 (25%) were anticoagulated. In a median follow-up of 3.28±0.55 years, all-cause mortality occurred in two patients, recurrence of suspected venous thromboembolism (VTE) occurred in 12 (30%) of 40 patients, but none had confirmed recurrent thromboembolism on further imaging. In the 40 patients with SSPE on V/Q, there was no difference...Continue Reading

References

Jun 2, 2006·The New England Journal of Medicine·Paul D SteinUNKNOWN PIOPED II Investigators
Jun 30, 2009·European Journal of Nuclear Medicine and Molecular Imaging·M BajcUNKNOWN EANM Committee
Apr 11, 2014·European Journal of Nuclear Medicine and Molecular Imaging·Pierre-Yves Le RouxPierre-Yves Salaun
Mar 17, 2015·Journal of Thrombosis and Thrombolysis·R Ikesaka, M Carrier

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