Latest & greatest articles for pulmonary embolism

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Top results for pulmonary embolism

101. Do patients with a clinically suspected subsegmental pulmonary embolism need anticoagulation therapy?

: 26th August 2015 Last Modified: 26th August 2015 Status: Green (complete) Three Part Question In [a symptomatic patient with an isolated subsegmental pulmonary embolism] does [anticoagulation therapy or no treatment] lead to [lower rates of mortality and recurrent venous thromboembolism?] Clinical Scenario A 62-year-old gentleman attends your Emergency Department with shortness of breath and chest pain. You suspect a pulmonary embolism (PE) and request a CT pulmonary angiogram. The radiologist (...) AK, et al . The significance of venography in the management of patients with clinically suspected pulmonary embolism. J Intern Med 1991;230:333–9. Stein PD, Henry JW, Relyea B . Untreated patients with pulmonary embolism. Outcome, clinical and laboratory assessment. Chest 1995;107:931–5. Donato AA, Khoche S, Santora J, et al . Clinical outcomes in patients with isolated subsegmental pulmonary emboli diagnosed by multidetector CT pulmonary angiography. Thromb Res 2010;126:e266–70. den Exter PL

2015 BestBETS

102. Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism

Edoxaban for treating and for preventing deep vein thrombosis and pulmonary embolism Edo Edoxaban for treating and for pre xaban for treating and for prev venting enting deep v deep vein thrombosis and pulmonary ein thrombosis and pulmonary embolism embolism T echnology appraisal guidance Published: 26 August 2015 nice.org.uk/guidance/ta354 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our (...) , to advance equality of opportunity and to reduce health inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Deep vein thrombosis, pulmonary embolism (treatment, secondary prevention) - edoxaban tosylate (TA354) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions

2015 National Institute for Health and Clinical Excellence - Technology Appraisals

103. Fibrinolysis for patients with intermediate-risk pulmonary embolism

Fibrinolysis for patients with intermediate-risk pulmonary embolism PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2015 PedsCCM Evidence-Based Journal Club

104. Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism (Abstract)

Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism For patients with acute symptomatic pulmonary embolism (PE), the Bova score classifies their risk for PE-related complications within 30 days after diagnosis. The original Bova score was derived from 2,874 normotensive patients with acute PE who participated in one of six prospective PE studies.We retrospectively assessed the validity

2015 EvidenceUpdates

105. Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial. Full Text available with Trip Pro

Six Months vs Extended Oral Anticoagulation After a First Episode of Pulmonary Embolism: The PADIS-PE Randomized Clinical Trial. The optimal duration of anticoagulation after a first episode of unprovoked pulmonary embolism is uncertain.To determine the benefits and harms of an additional 18-month treatment with warfarin vs placebo, after an initial 6-month nonrandomized treatment period on a vitamin K antagonist.Randomized, double-blind trial (treatment period, 18 months; median follow-up, 24 (...) months); 371 adult patients who had experienced a first episode of symptomatic unprovoked pulmonary embolism (ie, with no major risk factor for thrombosis) and had been treated initially for 6 uninterrupted months with a vitamin K antagonist were randomized and followed up between July 2007 and September 2014 in 14 French centers.Warfarin or placebo for 18 months.The primary outcome was the composite of recurrent venous thromboembolism or major bleeding at 18 months after randomization. Secondary

2015 JAMA Controlled trial quality: predicted high

106. Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults (Abstract)

Comparison of Wells and Revised Geneva Rule to Assess Pretest Probability of Pulmonary Embolism in High-Risk Hospitalized Elderly Adults To assess and compare the diagnostic power for pulmonary embolism (PE) of Wells and revised Geneva scores in two independent cohorts (training and validation groups) of elderly adults hospitalized in a non-emergency department.Prospective clinical study, January 2011 to January 2013.Unit of Internal Medicine inpatients, University of Catania, Italy.Elderly (...) adults (mean age 76 ± 12), presenting with dyspnea or chest pain and with high clinical probability of PE or D-dimer values greater than 500 ng/mL (N = 203), were enrolled and consecutively assigned to a training (n = 101) or a validation (n = 102) group. The clinical probability of PE was assessed using Wells and revised Geneva scores.Clinical examination, D-dimer test, and multidetector computed angiotomography were performed in all participants. The accuracy of the scores was assessed using

2015 EvidenceUpdates

107. Ultrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism

update the guidance on publication of further evidence. 2 2 Indications and current treatments Indications and current treatments 2.1 Pulmonary embolism (PE) is a condition in which a thrombus, most commonly from a deep vein thrombosis (DVT) in the legs or pelvis, obstructs the pulmonary arterial system. Symptoms of PE depend on the extent of obstruction to the pulmonary arteries: they include chest pain, dyspnoea and haemoptysis. In severe cases PE can result in reduced cardiac output, cardiogenic (...) Ultrasound-enhanced, catheter-directed thrombolysis for pulmonary embolism Ultr Ultrasound-enhanced, catheter-directed asound-enhanced, catheter-directed thrombolysis for pulmonary embolism thrombolysis for pulmonary embolism Interventional procedures guidance Published: 26 June 2015 nice.org.uk/guidance/ipg524 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

108. Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism

Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism Apixaban for the treatment and Apixaban for the treatment and secondary pre secondary prev vention of deep v ention of deep vein ein thrombosis and/or pulmonary embolism thrombosis and/or pulmonary embolism T echnology appraisal guidance Published: 4 June 2015 nice.org.uk/guidance/ta341 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions (...) due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Apixaban for the treatment and secondary prevention of deep vein thrombosis and/or pulmonary embolism (TA341) © NICE 2018. All rights reserved

2015 National Institute for Health and Clinical Excellence - Technology Appraisals

109. Dabigatran (Pradaxa) in deep vein thrombosis and pulmonary embolism

Dabigatran (Pradaxa) in deep vein thrombosis and pulmonary embolism Prescrire IN ENGLISH - Spotlight ''In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism'', 1 June 2015 {1} {1} {1} | | > > > In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |  (...)  |   |   |   |   |  Spotlight In the June issue of Prescrire International: Dabigatran (Pradaxa°) in deep vein thrombosis and pulmonary embolism FREE DOWNLOAD In the New Products section of the June issue: compared with adjusted-dose warfarin, dabigatran provides no tangible advantages for patients with pulmonary embolism or deep vein thrombosis. Warfarin remains the standard drug. Full text available for free download. Summary The anticoagulant dabigatran

2015 Prescrire

110. Treatment of pulmonary embolism with rivaroxaban: outcomes by simplified Pulmonary Embolism Severity Index score from a post hoc analysis of the EINSTEIN PE study Full Text available with Trip Pro

Treatment of pulmonary embolism with rivaroxaban: outcomes by simplified Pulmonary Embolism Severity Index score from a post hoc analysis of the EINSTEIN PE study The objective was to assess adverse outcomes in relation to the simplified Pulmonary Embolism Severity Index (PESI) score in patients treated with rivaroxaban or standard therapy in the phase III EINSTEIN PE study and to evaluate the utility of the simplified PESI score to identify low-risk pulmonary embolism (PE) patients.A post hoc

2015 EvidenceUpdates Controlled trial quality: uncertain

111. Should we use an age adjusted D-dimer threshold in managing low risk patients with suspected pulmonary embolism?

District Hospital, York, UK Date Submitted: 26th December 2014 Date Completed: 6th May 2015 Last Modified: 6th May 2015 Status: Green (complete) Three Part Question In [patients with signs and symptoms of pulmonary embolism who are deemed low risk] is a [age adjusted D-dimer sensitive enough] compared to a standard D-dimer to [safely exclude pulmonary embolism]? Clinical Scenario A70 year old man presents with pleuritic chest pain. A D-dimer taken at triage is mildly elevated from the standard positive (...) Bottom Line In older patients suspected of having a PE, with a low pretest possibility, an age-adjusted D-dimer increases specificity with minimal change in the sensitivity, thereby increasing the number of patients who can be safely discharged without further investigations. References Woller SC, Stevens SM, Adams DM et al. Assessment of the safety and efficiency of using an age-adjusted d-dimer threshold to exclude suspected pulmonary embolism Chest. 2014;146:1444–51. Vossen JA, Albrektson J

2015 BestBETS

112. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. Full Text available with Trip Pro

Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. Although retrievable inferior vena cava filters are frequently used in addition to anticoagulation in patients with acute venous thromboembolism, their benefit-risk ratio is unclear.To evaluate the efficacy and safety of retrievable vena cava filters plus anticoagulation vs anticoagulation alone for preventing pulmonary embolism (...) recurrence in patients presenting with acute pulmonary embolism and a high risk of recurrence.Randomized, open-label, blinded end point trial (PREPIC2) with 6-month follow-up conducted from August 2006 to January 2013. Hospitalized patients with acute, symptomatic pulmonary embolism associated with lower-limb vein thrombosis and at least 1 criterion for severity were assigned to retrievable inferior vena cava filter implantation plus anticoagulation (filter group; n = 200) or anticoagulation alone

2015 JAMA Controlled trial quality: predicted high

113. Pulmonary Embolism (PE): Diagnosis

such as SPECT V/Q, has high sensitivity and specificity in patients with a normal chest X-ray who do not have significant lung disease. V/Q scanning should be considered in patients with renal insufficiency, contrast allergy and in young patients with a normal chest X-ray. © 2015 Thrombosis Canada Page 3 of 3 FIGURE 1: SUGGESTED DIAGNOSTIC ALGORITHM FOR SUSPECTED PULMONARY EMBOLISM * Consideration for thrombolysis without diagnostic test confirmation should be made if the patient has a high clinical (...) Pulmonary Embolism (PE): Diagnosis © 2015 Thrombosis Canada Page 1 of 1 PULMONARY EMBOLISM (PE): DIAGNOSIS OBJECTIVE: To provide a diagnostic approach to patients with suspected acute pulmonary embolism (PE). BACKGROUND: Venous thromboembolism (VTE) is a common disease, affecting approximately 1-2 in 1,000 adults per year. Approximately one third of first VTE presentations are due to PE while the remainder is due to deep vein thrombosis (DVT). The diagnosis of PE has increased significantly

2015 Thrombosis Interest Group of Canada

114. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis

Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2015 PedsCCM Evidence-Based Journal Club

115. Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department (Abstract)

Predictive value of the heart-type fatty acid-binding protein and the Pulmonary Embolism Severity Index in patients with acute pulmonary embolism in the emergency department Heart-type fatty acid-binding protein (h-FABP), sensitive troponins, natriuretic peptides, and clinical scores such as the Pulmonary Embolism Severity Index (PESI) are candidates for risk stratification of patients with acute pulmonary embolism (PE). The aim was to compare their respective prognostic values to predict

2015 EvidenceUpdates

116. Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy?

their clinical judgment in this patient group until level 1 evidence can be provided and potentially modernise current practice References Schultz DJ, Brasel KJ, Washington L, et al. Incidence of asymptomatic pulmonary embolism in moderately to severely injured trauma patients. J Trauma 2004; 56: 727-733, Engelke C, Rummeny EJ, Marten K. Pulmonary embolism at multi-detector row CT of chest: One year survival of treated and untreated patients. Radiology 2006; 239: 563- 575. Sun JM, Kim TS, Lee J et al (...) Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? BestBets: Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? Do patients with an asymptomatic sub-segmental pulmonary embolism need anticoagulation therapy? Report By: Hyun Choi - CT3 Search checked by Christopher Morgan - Institution: Central Manchester University Hospitals NHS Foundation Trust, University Of Manchester Date Submitted: 27th November 2010

2015 BestBETS

117. Randomised controlled trial: An IVC filter and anticoagulation for 3?months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism

Randomised controlled trial: An IVC filter and anticoagulation for 3?months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism An IVC filter and anticoagulation for 3 months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings (...) months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism Article Text Therapeutics/Prevention Randomised controlled trial An IVC filter and anticoagulation for 3 months is unlikely to show a benefit over anticoagulation alone for high-risk patients with acute pulmonary embolism Eric K Hoffer Statistics from Altmetric.com Commentary on: Mismetti P , Laporte S , Pellerin O , et al ; PREPIC2 Study Group. Effect of a retrievable inferior vena

2015 Evidence-Based Medicine

118. Rapid Quantitative D-dimer to Exclude Pulmonary Embolism: A Prospective Cohort Management Study Full Text available with Trip Pro

Rapid Quantitative D-dimer to Exclude Pulmonary Embolism: A Prospective Cohort Management Study ESSENTIALS: It is not known if D-dimer testing alone can safely exclude pulmonary embolism (PE). We studied the safety of using a quantitative latex agglutination D-dimer to exclude PE in 808 patients. 52% of patients with suspected PE had a negative D-dimer test and were followed for 3 months. The negative predictive value of D-dimer testing alone was 99.8%, suggesting it may safely exclude (...) PE.Strategies are needed to exclude pulmonary embolism (PE) efficiently without the need for imaging tests. Although validated rules for clinical probability assessment can be combined with D-dimer testing to safely exclude PE, the rules can be complicated or partially subjective, which limits their use.To determine if PE can be safely excluded in patients with a negative D-dimer without incorporating clinical probability assessment.We enrolled consecutive outpatients and inpatients with suspected PE from

2015 EvidenceUpdates

119. Inferior Vena Cava Filters for Prevention of Pulmonary Embolism

Inferior Vena Cava Filters for Prevention of Pulmonary Embolism 1 COVERAGE GUIDANCE: INFERIOR VENA CAVA FILTERS FOR PREVENTION OF PULMONARY EMBOLI Approved March 12, 2015 HERC COVERAGE GUIDANCE Inferior vena cava (IVC) filters are recommended for coverage in: ? Patients with active deep vein thrombosis/pulmonary embolism (DVT/PE) for which anticoagulation is contraindicated (strong recommendation) ? Some hospitalized patients with trauma* (weak recommendation) Retrieval of removable IVC filters (...) -populations-130607.pdf Sobieraj, D.M., Coleman, C.I., Tongbram, V., Lee, S., Colby, J., Chen, W.T., et al. (2012). Venous thromboembolism in orthopedic surgery. Rockville, MD: AHRQ. Retrieved on October 2, 2014, from http://effectivehealthcare.ahrq.gov/ehc/products/186/992/CER- 49_VTE_20120313.pdf Young, T., Tang, H., & Hughes, R. (2010). Vena caval filters for the prevention of pulmonary embolism. Cochrane Database Syst Rev, 2(2). DOI: 10.1002/14651858.CD006212.pub4 Additional sources Decousus, H

2015 Oregon Health Evidence Review Commission

120. Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians Full Text available with Trip Pro

incidental findings on chest computed tomographic angiograms ordered to diagnose pulmonary embolism. Arch Intern Med 2009 169 1961 5 Duriseti RS , Brandeau ML . Cost-effectiveness of strategies for diagnosing pulmonary embolism among emergency department patients presenting with undifferentiated symptoms. Ann Emerg Med 2010 56 321 332 Ward MJ , Sodickson A , Diercks DB , Raja AS . Cost-effectiveness of lower extremity compression ultrasound in emergency department patients with a high risk (...) experience matter? Chest 2005 127 1627 30 Kline JA , Stubblefield WB . Clinician gestalt estimate of pretest probability for acute coronary syndrome and pulmonary embolism in patients with chest pain and dyspnea. Ann Emerg Med 2014 63 275 80 Wells PS , Anderson DR , Rodger M , Ginsberg JS , Kearon C , Gent M . et al Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED d -dimer. Thromb Haemost 2000 83 416 20 Gibson

2015 American College of Physicians