| Prospective study on the usefulness of lung scan in patients with deep vein thrombosis of the lower limbs. | |
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MedLine Citation:
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PMID: 11372666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Asymptomatic pulmonary embolism (PE) is a common finding in patients with deep venous thrombosis (DVT) of the lower limbs, but the usefulness of seeking for silent PE in patients with acute DVT has not been evaluated. PATIENTS AND METHODS: This was a prospective study involving consecutive patients with acute symptomatic proximal DVT (confirmed by objective methods) and no clinical suspicion of PE. All patients underwent chest X-ray, ventilation-perfusion lung scan and arterial blood gases on admission, and received anticoagulant therapy. Those with scintigraphic evidence of PE underwent repeated lung scan and blood gases 7 days later. The aim of the study was to assess how many patients with silent PE develop symptoms while on heparin therapy, and in how many of them such symptoms are due to recurrent PE. RESULTS: 946 consecutive patients with acute, proximal DVT had no contraindications to full-dose anticoagulant therapy. Baseline lung scan revealed high-probability defects (silent PE) in 200 (21%). Seven of these 200 patients had symptomatic recurrences during the 7-day study period, and an inferior vena cava filter was inserted. Besides, 6 patients developed PE symptoms, but no new perfusion defects were found on repeated scan. They switched to coumarin therapy, and they did not develop any further complications. CONCLUSIONS: Lung scan in patients with symptomatic DVT and no clinical suspicion of PE may be useful, since some patients with silent PE may develop symptoms while on heparin therapy. Without a baseline scintigraphy all these patients would have been considered to have recurrent PE, and vena cava interruption could have been performed. |
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Authors:
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M Monreal; J Ruiz; M Fraile; M Bonet; E Davant; J Muchart; V Vallejos |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Thrombosis and haemostasis Volume: 85 ISSN: 0340-6245 ISO Abbreviation: Thromb. Haemost. Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-24 Completed Date: 2002-02-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7608063 Medline TA: Thromb Haemost Country: Germany |
Other Details:
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Languages: eng Pagination: 771-4 Citation Subset: IM |
Affiliation:
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Hospital Universitari Germans Trias i Pujol de Badalona, Servei de Medicine Internal, Spain. mmonreal@ns.hugtip.scs.es |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Anticoagulants / pharmacology Blood Gas Analysis Female Follow-Up Studies Heparin / pharmacology Humans Leg / blood supply Lung / blood supply, radionuclide imaging* Male Middle Aged Prospective Studies Pulmonary Embolism / diagnosis*, epidemiology, etiology, radionuclide imaging* Recurrence Survival Rate Venous Thrombosis / complications*, drug therapy, epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 9005-49-6/Heparin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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