Frequency of Resolution of Pulmonary Embolism 6-Months Post Diagnosis and Initiation of Treatment

Authors

  • Amna Yousaf Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Rehan Shafique Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Usman Aslam Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Asma Zafar Khawaja Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Muhammad Masoom Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan
  • Zahid Hussain Department of Adult Cardiology, Armed Forces Institute of Cardiology/National Institute of Heart Diseases/ National University of Medical Sciences (NUMS) Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-3.10648

Keywords:

Computed Tomography Pulmonary Angiography, Pulmonary Arteries, Pulmonary Embolism.

Abstract

Objective: To determine the frequency of resolution of pulmonary embolism 6 months after diagnosis and treatment using CT pulmonary angiography.

Study Design: Analytical, Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from Dec 2022 to May 2023.

Methodology: This study was conducted on thirty-one patients with pulmonary embolism, enrolled by consecutive sampling technique. Patients underwent computed tomography pulmonary angiography (CTPA). Pulmonary embolism protocol was used for taking the computed tomography angiography and resolution of embolism was also assessed.

Results: Out of total 31 patients, males were 10(32.3%) and females were 21(67.7%). Mean age was 48.58±9.61 years. Prevalence of PE resolution and no resolution at all was 21(67.7%) and 10(32.3%) respectively. Thrombus in major pulmonary arteries was resolved in 15(68.1%) out of 22, while segmental arteries’ thrombus was resolved in 21(67.7%) out of 31 patients and there was significant association with the type of thrombolytic drug used (p<0.05).

Conclusion: The present study found that prevalence of PE complete resolution on CT angiography was 67.7%. Heparin gave comparatively good instant results. Resolution was comparatively low in smokers, diabetic and cancer patients while 0.0% resolution of PE was observed in patients with hypercoagulability.

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References

Stein PD, Yaekoub AY, Matta F, Janjua M, Patel RM, Goodman LR, et al. Resolution of pulmonary embolism on CT pulmonary angiography. Am J Roentgenol 2010; 194(5): 1263–1268. https://doi.org/10.2214/AJR.09.3410

Gjonbrataj E, Kim JN, Gjonbrataj J, Jung HI, Kim HJ, Choi WI. Risk factors associated with provoked pulmonary embolism. Korean J Intern Med 2017; 32(1): 95.

https://doi.org/10.3904/kjim.2015.118

Bukhari SI, Khan MB, Zahir A, Alam S, Ullah F. Venous Thromboembolism With The Use Of Aspirin Versus Enoxaparin As Prophylactic Agents After Hip Arthroplasty. Journal of Postgraduate Medical Institute. 2023 Mar 1; 37(1): 62.

https://doi.org/10.54079/jpmi.37.1.3151

Turetz M, Sideris AT, Friedman OA, Triphathi N, Horowitz JM. Epidemiology, Pathophysiology, and Natural History of Pulmonary Embolism. Semin Interv Radiol 2018; 35(2): 92–98. https://doi.org/10.1055/s-0038-1642036

Rivera-Lebron B, McDaniel M, Ahrar K, Alrifai A, Dudzinski DM, Fanola C, et al. Diagnosis, treatment and follow up of acute pulmonary embolism: consensus practice from the PERT Consortium. Clin Appl Thromb 2019; 25.

https://doi.org/10.1177/1076029619853

Young T, Sriram KB. Vena caval filters for the prevention of pulmonary embolism. Cochrane Database Syst Rev 2020; (10). https://doi.org/10.1002/14651858.CD006212.pub5

Chaudhary N, Khan UH, Shah TH, Shaheen F, Mantoo S, Qadri SM, et al. Prevalence and predictors of pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease. Lung India Off Organ Indian Chest Soc 2021; 38(6): 533.

https://doi.org/10.4103/lungindia.lungindia_79_21

Freund Y, Cohen-Aubart F, Bloom B. Acute Pulmonary Embolism: A Review. JAMA. 2022; 328(13): 1336–1345.

https://doi.org/10.1001/jama.2022.16815

Ak M, Gumus S, Aghayev A, Chang CH, Fu B, Roberts MS, et al. The Resolution Rate of Pulmonary Embolism on CT Pulmonary Angiography: a Prospective Study. Eur J Radiol 2022; 155: 110466.

https://doi.org/10.1016/j.ejrad.2022.110466

Barco S, Mahmoudpour SH, Valerio L, Klok FA, Münzel T, Middeldorp S, et al. Trends in mortality related to pulmonary embolism in the European Region, 2000–15: analysis of vital registration data from the WHO Mortality Database. Lancet Respir Med 2020; 8(3): 277–287.

https://doi.org/10.1016/S2213-2600(19)30354-6

Zuo Z, Yue J, Dong BR, Wu T, Liu GJ, Hao Q. Thrombolytic therapy for pulmonary embolism. Cochrane Database Syst Rev 2021; (4).

https://doi.org/10.1002/14651858.CD004437

Keller K, Hobohm L, Ebner M, Kresoja KP, Münzel T, Konstantinides SV, et al. Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany. Eur Heart J 2020; 41(4): 522–529.

https://doi.org/10.1093/eurheartj/ehz236

Ucar EY. Update on thrombolytic therapy in acute pulmonary thromboembolism. Eurasian J Med 2019; 51(2): 186. https://doi.org/10.5152/eurasianjmed.2019.19291

Goldhaber SZ, Come PC, Lee RT, Braunwald E, Parker JA, Haire WD, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. The Lancet 1993; 341(8844): 507–511.

https://doi.org/10.1016/0140-6736(93)90274-K

Sharma G, Burleson VA, Sasahara AA, Roggeveen B, Mondello N, Guilford H. Effect of thrombolytic therapy on pulmonary-capillary blood volume in patients with pulmonary embolism. N Engl J Med 1980; 303(15): 842–845.

https://doi.org/10.1056/NEJM198010093031502

Bergh E, Jahr SH, Rønning OM, Askim T, Thommessen B, Kristoffersen ES. Reasons and predictors of non-thrombolysis in patients with acute ischemic stroke admitted within 4.5 h. Acta Neurol Scand 2022; 146(1): 61–69.

https://doi.org/10.1111/ane.13622

Kucher N, Ouda A, Voci D, Barco S, Micieli E, Münger M, et al. Percutaneous large-bore aspiration embolectomy with veno-arterial extracorporal membrane oxygenation support or standby in patients with high-risk pulmonary embolism and contraindications to thrombolysis: a preliminary single centre experience. Eur Heart J Acute Cardiovasc Care 2023; 12(4): 232–236.

https://doi.org/10.1093/ehjacc/zuad014

Lavonas EJ, Drennan IR, Gabrielli A, Heffner AC, Hoyte CO, Orkin AM, et al. Part 10: special circumstances of resuscitation: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015; 132(18_suppl_2): S501–518. https://doi.org/10.1161/CIR.0000000000000264

Ak M, Gumus S, Aghayev A, Chang CH, Fu B, Roberts MS, et al. The Resolution Rate of Pulmonary Embolism on CT Pulmonary Angiography: a Prospective Study. Eur J Radiol 2022; 155: 110466.

https://doi.org/10.1016/j.ejrad.2022.110466

López-Beret P, Pinto JM, Romero A, Orgaz A, Fontcuberta J, Oblas M. Systematic study of occult pulmonary thromboembolism in patients with deep venous thrombosis. J Vasc Surg 2001; 33(3): 515–521.

https://doi.org/10.1067/mva.2001.111978

Alonso-Martínez JL, Anniccherico-Sánchez FJ, Urbieta-Echezarreta MA, García-Sanchotena JL, Herrero HG. Residual pulmonary thromboemboli after acute pulmonary embolism. Eur J Intern Med 2012; 23(4): 379–383.

https://doi.org/10.1016/j.ejim.2011.08.018

Aghayev A, Furlan A, Patil A, Gumus S, Jeon KN, Park B, et al. The rate of resolution of clot burden measured by pulmonary CT angiography in patients with acute pulmonary embolism. AJR Am J Roentgenol 2013; 200(4): 791.

https://doi.org/10.2214/AJR.12.8624

Van Rossum AB, , Kieft GJ. Spiral CT appearance of resolving clots at 6 week follow-up after acute pulmonary embolism. J Comput Assist Tomogr 1998; 22(3): 413–417.

Van Es J, Douma RA, Kamphuisen PW, Gerdes VEA, Verhamme P, Wells PS, et al. Clot resolution after 3 weeks of anticoagulant treatment for pulmonary embolism: comparison of computed tomography and perfusion scintigraphy. J Thromb Haemost 2013; 11(4): 679–685.

https://doi.org/10.1111/jth.12150

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Published

30-05-2025

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Original Articles

How to Cite

1.
Yousaf A, Shafique R, Aslam U, Khawaja AZ, Masoom M, Hussain Z. Frequency of Resolution of Pulmonary Embolism 6-Months Post Diagnosis and Initiation of Treatment. Pak Armed Forces Med J [Internet]. 2025 May 30 [cited 2025 Aug. 23];75(SUPPL-3):S404-S409. Available from: https://www.pafmj.org/PAFMJ/article/view/10648