title: Subsegmental pulmonary embolism: A narrative review.
abstract: Through the introduction of computed tomography pulmonary angiography (CTPA) for diagnosis of the pulmonary embolism (PE), the high sensitivity of this diagnostic tool led to detecting peripheral filling defects as small as 2-3mm, termed as subsegmental pulmonary embolism (SSPE). However, despite these substantial increases in diagnosis of small pulmonary embolism, there are minimal changes in mortality. Moreover, SSPE patients generally are hemodynamically stable with mild clinical presentation, lower serum level of biomarkers, lower incidence of associated proximal DVTs and less frequent echocardiographic changes compared to the patients with emboli located in more central pulmonary arteries. However, the pros and cons of anticoagulant therapy versus non-treating, monitoring protocol and exact long term outcome of these patients are still unclear. In this article we review existing evidence and provide an overview of what is known about the diagnosis and management of subsegmental pulmonary embolism.
authors.affiliation: Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: s-peiman@tums.ac.ir.
authors.forename: Soheil
authors.initials: S
authors.lastname: Peiman
authors.affiliation: Department of Nuclear Medicine, Vali-asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrshad
authors.initials: M
authors.lastname: Abbasi
authors.affiliation: Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Farshad
authors.initials: SF
authors.lastname: Allameh
authors.affiliation: Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mehrnaz
authors.initials: M
authors.lastname: Asadi Gharabaghi
authors.affiliation: Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Abtahi
authors.affiliation: Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Enayat
authors.initials: E
authors.lastname: Safavi
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D019468:Disease Management; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D020246:Venous Thrombosis / Q000150:complications
chemical_list: D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: Anticoagulants; Disease management; Multidetector computed tomography; Perfusion imaging; Pulmonary embolism