Refined CT imaging can identify residual thrombi 1 year after acute Pulmonary embolism
Japan: A team of researchers from Japan reported a high prevalence (74%) of residual thrombi 1 year after acute pulmonary embolism (PE) using refined computed tomography (CT) imaging. Precise CT imaging can therefore be included in the long-term treatment strategy of acute PE. The findings of the study appear in the Journal of Thrombosis and Haemostasis.
Post-pulmonary embolism syndrome is an important clinical condition that can impact the long-term prognosis after acute PE. Yoshihisa Nakano and colleagues aimed to evaluate the prevalence of residual pulmonary thrombi and the thrombotic burden 1 year after acute PE, by using a refined CT imaging method in a prospective study.
The researchers recruited patients diagnosed with acute PE and examinations were conducted at 1 month, 6 months, and 1 year. Especially at 1 year, patients were evaluated multifacetedly, including laboratory tests, 6-min walking test, quality-of-life, and enhanced CT.
The findings of the study were as follows:
- Fifty-two patients were enrolled. Two patients (3.8%) developed chronic thromboembolic pulmonary hypertension.
- A total of 43 patients completed evaluation at 1 year, among whom (74%) had residual thrombi, with a median modified CT obstruction index (mCTOI) of 10.7%.
- In multivariate analysis, residual thrombi at 1 month was the only factor significantly related to residual thrombi at 1 year (odds ratio, 103.4).
- The tricuspid regurgitation pressure gradient ≥60 mmHg and left ventricular end-diastolic dimension at diagnosis were significantly related to mCTOI at 1 year (β = 0.367 and β = –0.435 respectively).
"We found a high incidence of residual pulmonary thrombi 1 year after acute PE using enhanced CT imaging protocol. Furthermore, right ventricular overload was significantly related to the thrombotic burden," the researchers wrote in their study.
They suggest, that "the treatment strategy for acute PE should include the modified CT imaging protocol with mCTOI for accurately monitoring residual pulmonary thrombotic burden."
Reference:
The study titled, "Usefulness of a refined computed tomography imaging method to assess the prevalence of residual pulmonary thrombi in patients 1 year after acute pulmonary embolism: The Nagoya PE study," was published in the Journal of Thrombosis and Haemostasis.
