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Autopsy-proven untreated previous pulmonary thromboembolism: frequency and distribution in the pulmonary artery and correlation to patients' clinical characteristics.
MedLine Citation:
PMID:  21294826     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: This study aimed to evaluate untreated, previous pulmonary thromboembolism (PE) in patients with acute fatal PE. Patients and Methods: We studied 64 patients diagnosed to have died from acute PE by medico-legal autopsy. Previous PE was histologically confirmed on the basis of organized thrombi (OT). The distributions of OT were analyzed in five different sizes of pulmonary artery branches in each of 18 pulmonary segmental arteries; 90 in total. The frequency of OT in each patient was evaluated by determining the percentage of examined sections containing OT. Results: OT were confirmed in 59 of 64 (92%) patients. The mean frequency of OT per patient was 27% of the 90 branches. Among the segmental arteries, the right posterior basal lobe showed the highest frequency of OT; among the five artery branches examined, the subsegmental branch showed the highest frequency of OT. OT were not detected in arterioles. Patients with recent trauma or operation and inpatients showed significantly lower frequencies of OT than those without these risk factors. The 26 patients with prolonged preexisting symptoms lasting more than a day showed a higher frequency of OT than the 12 patients who suffered for less than a day and the 26 without preexisting symptoms. Conclusions: Most patients with acute fatal PE have a subclinical history of recurrent PE. The frequency of their untreated PE is suspected to correlate with specific risk factors for venous thromboembolism and their clinical course.
Authors:
A Ro; N Kageyama; T Tanifuji; M Sakuma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-5
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  -     ISSN:  1538-7836     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 International Society on Thrombosis and Haemostasis.
Affiliation:
Department of Legal Medicine, School of Medicine, Tokyo Women's Medical University, Tokyo Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Tokyo Division of Cardiology, Department of Internal Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
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