Clinical characteristics of patients with peripheral pulmonary embolism.
BACKGROUND
The clinical relevance of emboli limited to the segmental or sub-segmental pulmonary arteries and the role of anticoagulation in patients with these conditions remains to be clarified.


OBJECTIVE
To determine the clinical characteristics and treatment outcomes of peripheral pulmonary embolism (PE), and in particular, isolated sub-segmental PE (ISSPE).


METHODS
We reviewed the data for 334 patients who were diagnosed with a PE by computed tomographic (CT) pulmonary angiography and indirect CT venography.


RESULTS
All patients were classified into one of three groups: central (245 patients, 73.4%); segmental (67 patients, 20.1%), and sub-segmental (22 patients, 6.6%). An incidental CT finding (63.6%) was the most common presentation in the segmental and sub-segmental groups. Compared with the central group, the sub-segmental group had less frequent proximal deep venous thrombosis (14 vs. 47%, Bonferroni's corrected p = 0.002), and greater preservation of oxygenation levels (p < 0.05) without hemodynamic instability. The recurrence of PE and deaths related to PE did not occur in the sub-segmental group, although approximately 30% of the patients did not receive anticoagulation therapy.


CONCLUSIONS
Patients with ISSPE may have a more benign clinical presentation, as compared to the central type, and may follow a good clinical course without mortality or recurrence.
Cha
Seung-Ick
SI
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea. sicha@knu.ac.kr
Shin
Kyung-Min
KM
Lee
Jung-Woo
JW
Lee
Jongmin
J
Lee
Shin-Yup
SY
Kim
Chang-Ho
CH
Park
Jae-Yong
JY
Jung
Tae-Hoon
TH
D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D000925:Anticoagulants