Non-invasive diagnosis of pulmonary embolism.

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Non-invasive diagnosis of pulmonary embolism.

Chest. 2010 Aug 19;

Authors: Salaun PY, Couturaud F, LE Duc-Pennec A, Lacut K, LE Roux PY, Guillo P, Pennec PY, Cornily JC, Leroyer C, LE Gal G

AbstractBackground We designed a simple and integrated diagnostic algorithm for acute pulmonary embolism (PE). Diagnosis was based on clinical probability assessment, plasma D-Dimer testing, then sequential testing to include lower limb venous compression ultrasonography, ventilation perfusion lung scan and chest multi-detector computed tomography (MDCT). Methods We included 321 consecutive patients presenting at the University Hospital of Brest, Brest, France with clinically suspected PE and positive D-dimer or high clinical probability. Patients in whom venous thromboembolism was deemed absent were not given anticoagulants and were followed up for 3 months. Results Detection of deep vein thrombosis by ultrasonography established the diagnosis of PE in 43 (13%). Lung scan associated with clinical probability was diagnostic in 243 (76%) of the remaining patients. MDCT scan was required in only 35 (11%) of the patients. The 3- month thromboembolic risk in patients not given anticoagulants, based on the results of the diagnostic protocol, was 0.53% (95% CI 0.09-2.94). Conclusions A diagnostic strategy combining clinical assessment, D-dimer, ultrasonography, and lung scan gave a non-invasive diagnosis in the vast majority of outpatients with suspected pulmonary embolism, and appeared to be safe.

PMID: 20724733 [PubMed - as supplied by publisher]

One Comment

  1. Bonjour, je suis jeune docteur de Saint-Pétersbourg. J”ai commencé travailler pour le teses du même sujet. Le diagnostic DVT PE seulement chez de jeunes patients(Jusqu’à 45 ans). Mais je n’ai pas beaucoup de patients.Aidez moi, s’il vous plaît avec la caractéristique clinique de vos jeunes patients, les facteurs du risque et la génétique, si c’est possible. D’avance merci

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