Noninvasive diagnosis and treatment of a saddle pulmonary embolism. A case report in support of new trends in management of pulmonary embolism.

@article{Torbicki1996NoninvasiveDA,
  title={Noninvasive diagnosis and treatment of a saddle pulmonary embolism. A case report in support of new trends in management of pulmonary embolism.},
  author={Adam Torbicki and Ryszard Pacho and Piotr Jędrusik and Piotr Pruszczyk},
  journal={Chest},
  year={1996},
  volume={109 4},
  pages={
          1124-6
        }
}
Transesophageal echocardiography and contrast-enhanced spiral CT of the chest helped to avoid a pulmonary angiography in an elderly patient with saddle pulmonary thromboembolism and allowed for direct evaluation of its resolution during treatment with subcutaneous low molecular weight heparin. 
View on PubMed
journal.publications.chestnet.org
13 Citations
Background Citations
1

13 Citations

Citation Type

Citation Type

Should Transesophageal Echocardiography Become a Routine Test in Patients with Suspected Pulmonary Thromboembolism?
TLDR
Transesophageal echocardiography (TEE) is a fast, fairly sensitive, and highly specific diagnostic bedside modality to select surgical candidates with CTEPH and should become a routine test in patients with suspected massive acute PE, suspected right heart thrombi, or paradoxical embolism associated with acute pulmonary embolist.
Short term clinical outcome of acute saddle pulmonary embolism
Wider application of spiral computed tomography (CT) not only improves diagnosis of acute pulmonary embolism (PE) (fig 1), but also allows for non-invasive visualisation of saddle thromboemboli at…
Life threatening massive pulmonary embolism treated with reteplase: a case report.
  • C. Theron, D. C. Laidlow
  • Medicine
    Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine
  • 2000
TLDR
This case highlights the utility of reteplase in the management of an acute pulmonary embolism and in an emergency, recent surgery is not necessarily a contraindication to its use.
The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism.
TLDR
It is shown that patients with SE, determined with CTA, is associated with the development of MAE within 1 month, and may be a simple method for risk stratification of patients with non-high-risk PE.
Noninvasive diagnosis of suspected severe pulmonary embolism: transesophageal echocardiography vs spiral CT.
TLDR
Because of high prevalence of bilateral central pulmonary thromboemboli in patients with hemodynamically significant PE, both sCT and TEE allow its definitive confirmation in most cases.
Short-term mortality of patients with saddle pulmonary embolism: A single-center study.
TLDR
The results of this study indicated that SPE had a statistically significant importance in predicting in-hospital mortality and adverse events in PE patients, and were not consistent with many prior studies.
A fast-track diagnostic and therapeutic strategy for acute pulmonary embolism patients at peri-operational period
Electron Beam Tomography of Interpulmonary Saddle Embolism: Extent and Vascular Distribution
TLDR
Interpulmonary saddle emboli appear to be a transient form of acute pulmonary embolism, the site of predilection for rupture of the embolus being the level of the bifurcation, and their frequency may be underestimated.
Systematic study of occult pulmonary thromboembolism in patients with deep venous thrombosis.
TLDR
The incorporation of this exploration in the systematic diagnostic strategy of most patients with DVT to establish the extension of thromboembolic disease at diagnosis may be useful in the evaluation of added pulmonary artery symptoms and treatment strategies.
Central pulmonary artery lesions in chronic obstructive pulmonary disease: A transesophageal echocardiography study.
TLDR
TEE often reveals CPA lesions in stable patients with COPD even in the absence of significant pulmonary hypertension and not in close relation with the severity of pulmonary dysfunction, supporting an atherosclerotic origin of type 2 lesions, which were different from typical thrombotic lesions.
...
1
2
...

References

SHOWING 1-10 OF 13 REFERENCES
[A dissecting aortic aneurysm with unilateral compression of the pulmonary artery].
A case of aortic aneurysm associated with unilateral compression of one pulmonary artery is presented. The combination of a mediastinal tumor and unilateral high transparency of the lung in the…
Transoesophageal echocardiography for definitive diagnosis of haemodynamically significant pulmonary embolism.
TLDR
Direct visualization of proximal pulmonary arterial thrombi by transoesophageal echocardiography emerges as a useful new method of prompt and definite diagnosis of haemodynamically important pulmonary embolism.
Risks for Major Bleeding from Thrombolytic Therapy in Patients with Acute Pulmonary Embolism: Consideration of Noninvasive Management
TLDR
The relative risks for bleeding with thrombolytic therapy in patients who were managed using pulmonary angiograms compared with those managed using noninvasive tests, primarily the ventilation-perfusion lung scan were assessed.
Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique--comparison with pulmonary angiography.
TLDR
In one case of normal pulmonary angiographic findings, asymmetry in pulmonary arterial perfusion was misinterpreted as pulmonary embolism with spiral volumetric CT, which can reliably depict thromboemboli in second- to fourth-division pulmonary vessels.
Reduced dose bolus alteplase vs conventional alteplase infusion for pulmonary embolism thrombolysis. An international multicenter randomized trial. The Bolus Alteplase Pulmonary Embolism Group.
TLDR
A reduced dose of bolus recombinant human tissue-type plasminogen activator (rt-PA) would result in fewer bleeding complications than standard 100 mg of rt-PA administered as a continuous infusion over 2 h among hemodynamically stable patients with pulmonary embolism (PE).
Randomized Trial of Subcutaneous Low‐Molecular‐Weight Heparin CY 216 (Fraxiparine) Compared With Intravenous Unfractionated Heparin in the Curative Treatment of Submassive Pulmonary Embolism: A Dose‐Ranging Study
TLDR
The Fraxiparine dosage of 400 anti-Xa Institute Choay units/kg is as effective and safe as unfractionated heparin in the treatment of submassive pulmonary embolism.
Pulmonary embolism: Diagnosis with contrast-enhanced electron-beam CT and comparison with pulmonary angiography
Transesophageal echocardiography for definitive diagnosis of pulmonary embo¬ lism
  • Eur Heart J
  • 1995
Pulmonary angiography in pulmonary embolism
Reduced dose bolus alteplase versus conventional alteplase infusion for pulmonary embolism thrombolysis: an international multicenter randomized trial
  • Chest
  • 1994
...
1
2
...