Diagnosis and treatment of subsegmental pulmonary embolism

• 作者: Alice M Turner Michael Newnham
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: Subsegmental PULMONARY EMBOLISM VENOUS THROMBOEMBOLISM INCIDENCE DIAGNOSIS Treatment
• 年，卷（期）: 2019,（3）
• 页码范围: 30-34
• 页数: 5页
• 分类号: R

摘要

Subsegmental pulmonary embolism (SSPE) affects the 4th division and more distal pulmonary arterial branches. SSPE can be isolated or affect multiple subsegments, be symptomatic or incidental (unsuspected) and may or may not be associated with deep vein thrombosis. Symptoms, clinical risk scores and biomarkers are less sensitive for diagnosing SSPE compared to more central pulmonary embolism. The diagnosis is confirmed using radiological imaging, predominately computed tomographic pulmonary angiogram (CTPA) or ventilation/perfusion scanning. The increasing utilization of CTPAs may have resulted in overdiagnosis driven by smaller pulmonary emboli. There is insufficient evidence of improved mortality or reduced venous thromboembolism recurrence with anticoagulation treatment for SSPE however, the major and clinically significant haemorrhage risks are well described. As the resolution of diagnostic imaging has improved, we may be viewing the natural physiological filtering process performed by the lungs that may not require treatment.