Contemporary approach to the diagnosis of non-massive pulmonary embolism

Current Opinion in Pulmonary Medicine

Volumn 12, Issue 5, 2006, Pages 291-298

  Le Gal, Grégoire ^a   Perrier, Arnaud ^b  

^a BREST UNIVERSITY HOSPITAL   (France)

^b GENEVA UNIVERSITY HOSPITALS   (Switzerland)

Author keywords

Clinical assessment; Computed tomography; D dimer; Diagnosis; Lower limb compression ultrasonography; Pulmonary embolism

Indexed keywords

COMPUTER ASSISTED TOMOGRAPHY; COST EFFECTIVENESS ANALYSIS; ECHOGRAPHY; EVALUATION; EVIDENCE BASED PRACTICE; HUMAN; LUNG ANGIOGRAPHY; LUNG EMBOLISM; POINT OF CARE TESTING; REVIEW; TREATMENT OUTCOME; VALIDATION PROCESS;

HUMANS; LOWER EXTREMITY; PHYSICAL EXAMINATION; PULMONARY EMBOLISM; RADIOGRAPHY, THORACIC; TOMOGRAPHY, X-RAY COMPUTED;

EID: 33748196060     PISSN: 10705287     EISSN: 15316971     Source Type: Journal    
DOI: 10.1097/01.mcp.0000239542.32455.9f     Document Type: Review

References (44)

1. Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. Lancet 1960; 1:1309-1312.
2. Buller HR, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126:401S-428S.
3. Le Gal G, Righini M, Roy PM, et al. Differential value of risk factors and clinical signs for diagnosing pulmonary embolism according to age. J Thromb Haemost 2005; 3:2457-2464. A study of the value of various symptoms and signs of pulmonary embolism in different age groups.
4. Stein PD, Athanasoulis C, Alavi A, et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation 1992; 85:462-468.
5. Roy PM, Colombet I, Durieux P, et al. Systematic review and meta-analysis of strategies for the diagnosis of suspected pulmonary embolism. BMJ 2005; 331:259. A recent systematic review of the performance of diagnostic tests for pulmonary embolism.
6. Wells PS, Ginsberg JS, Anderson DR, et al. Use of a clinical model for safe management of patients with suspected pulmonary embolism. Ann Intern Med 1998; 129:997-1005.
7. Perrier A, Desmarais S, Miron MJ, et al. Noninvasive diagnosis of venous thromboembolism in outpatients. Lancet 1999; 353:190-195.
8. Perrier A, Roy PM, Aujesky D, et al. Diagnosing pulmonary embolism in outpatients with clinical assessment, D-dimer measurement, venous ultrasound, and helical computed tomography: a multicenter management study. Am J Med 2004; 116:291-299.
9. Perrier A, Roy PM, Sanchez O, et al. Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 2005; 352:1760-1768. A multicentre study in which multidetector computed tomography and lower limb venous ultrasonography were performed in every patient, confirming the high negative predictive value of a negative MSCT.
10. Musset D, Parent F, Meyer G, et al. Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study. Lancet 2002; 360:1914-1920.
11. van Belle A, Buller HR, Huisman MV, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 2006; 295:172-179. The largest outcome study on plasma D-dimer measurement and multidetector computed tomography in suspected pulmonary embolism to date.
12. Bossuyt PM, Reitsma JB, Bruns DE, et al. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD Initiative. Ann Intern Med 2003; 138:40-44.
13. van Beek EJ, Brouwerst EM, Song B, et al. Clinical validity of a normal pulmonary angiogram in patients with suspected pulmonary embolism: a critical review. Clin Radiol 2001; 56:838-842.
14. Le Gal G, Righini M, Roy P-M, et al. Value of D-dimer testing for the exclusion of pulmonary embolism in patients with previous venous thromboembolism. Arch Intern Med 2006; 166:176-180. A retrospective analysis confirming the value of D-dimer for ruling out pulmonary embolism in patients with a previous thromboembolic event.
15. Wells PS, Anderson DR, Rodger M, et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D-dimer. Ann Intern Med 2001; 135:98-107.
16. Perrier A, Nendaz MR, Sarasin FP, et al. Cost-effectiveness of diagnostic strategies for suspected pulmonary embolism including helical computed tomography. Am J Respir Crit Care Med 2003; 167:39-44.
17. The PIOPED Investigators. Value of the ventilation-perfusion scan in acute pulmonary embolism. JAMA 1990; 263:2753-2759
18. Perrier A, Bounameaux H, Morabia A, et al. Diagnosis of pulmonary embolism by a decision analysis-based strategy including clinical probability, D-dimer levels, and ultrasonography: a management study. Arch Intern Med 1996; 156:531-536.
19. Wells PS, Anderson DR, Rodger 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; 83:416-420.
20. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in emergency patients: the revised Geneva score. Ann Intern Med 2006; 144:165-171. A new prediction rule to assess the clinical probability of pulmonary embolism, simple, completely standardized and relying only on clinical variables.
21. Wicki J, Perneger TV, Junod A, et al. Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 2001; 161:92-97.
22. Hildner FJ, Ormond RS. Accuracy of the clinical diagnosis of pulmonary embolism. JAMA 1967; 202:115-118.
23. Van Strijen MJ, De Monye W, Schiereck J, et al. Single-detector helical computed tomography as the primary diagnostic test in suspected pulmonary embolism: a multicenter clinical management study of 510 patients. Ann Intern Med 2003; 138:307-314.
24. Dunn KL, Wolf JP, Dorfman DM, et al. Normal D-dimer levels in emergency department patients suspected of acute pulmonary embolism. J Am Coll Cardiol 2002; 40:1475-1478.
25. Le Gal G, Bounameaux H. Diagnosing pulmonary embolism: running after the decreasing prevalence of cases among suspected patients. J Thromb Haemost 2004; 2:1244-1246.
26. Kline JA, Mitchell AM, Kabrhel C, et al. Clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2004; 2:1247-1255.
27. Righini M, Le Gal G, Perrier A, Bounameaux H. More on: clinical criteria to prevent unnecessary diagnostic testing in emergency department patients with suspected pulmonary embolism. J Thromb Haemost 2005; 3:188-189.
28. Stein PD, Hull RD, Patel KC, et al. D-Dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med 2004; 140:589-602.
29. Kelly J, Hunt BJ. A clinical probability assessment and D-dimer measurement should be the initial step in the investigation of suspected venous thromboembolism. Chest 2003; 124:1116-1119.
30. Di Nisio M, Sohne M, Kamphuisen PW, Buller HR. D-Dimer test in cancer patients with suspected acute pulmonary embolism. J Thromb Haemost 2005; 3:1239-1242.
31. Righini M, de Moerloose P, Reber G, et al. Should the D-dimer cut-off value be increased in elderly patients suspected of pulmonary embolism? Thromb Haemost 2001; 85:744.
32. Righini M, Goehring C, Bounameaux H, Perrier A. Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med 2000; 109:357-361.
33. Miron MJ, Perrier A, Bounameaux H, et al. Contribution of noninvasive evaluation to the diagnosis of pulmonary embolism in hospitalized patients. Eur Respir J 1999; 13:1365-1370.
34. Righini M, Aujesky D, Roy PM, et al. Clinical usefulness of D-dimer depending on clinical probability and cutoff value in outpatients with suspected pulmonary embolism. Arch Intern Med 2004; 164:2483-2487.
35. Eichinger S, Minar E, Bialonczyk C, et al. D-dimer levels and risk of recurrent venous thromboembolism. JAMA 2003; 290:1071-1074.
36. Palareti G, Legnani C, Cosmi B, et al. Predictive value of D-dimer test for recurrent venous thromboembolism after anticoagulation withdrawal in subjects with a previous idiopathic event and in carriers of congenital thrombophilia. Circulation 2003; 108:313-318.
37. Rodger MA, Bredeson CN, Jones G, et al. The bedside investigation of pulmonary embolism diagnosis study: a double-blind randomized controlled trial comparing combinations of 3 bedside tests vs ventilation-perfusion scan for the initial investigation of suspected pulmonary embolism. Arch Intern Med 2006; 166:181-187. A study evaluating the value of the Wells clinical prediction rule, D-dimer dosage and alveolar dead space fraction measurement, separately or in combination, to rule out pulmonary embolism.
38. Rémy-Jardin M, Rémy J, Wattinne L, Giraud F. Central pulmonary thromboembolism: diagnosis with spiral volumetric CT with the single-breath-hold technique: comparison with pulmonary angiography. Radiology 1992; 185:381-387.
39. Mullins MD, Becker DM, Hagspiel KD, Philbrick JT. The role of spiral volumetric computed tomography in the diagnosis of pulmonary embolism. Arch Intern Med 2000; 160:293-298.
40. Rathbun SW, Raskob GE, Whitsett TL. Sensitivity and specificity of helical computed tomography in the diagnosis of pulmonary embolism: a systematic review. Ann Intern Med 2000; 132:227-232.
41. Oser RF, Zuckerman DA, Gutierrez FR, Brink JA. Anatomic distribution of pulmonary emboli at pulmonary angiography: implications for cross-sectional imaging. Radiology 1996; 199:31-35.
42. Kearon C, Ginsberg JS, Hirsh J. The role of venous ultrasonography in the diagnosis of suspected deep venous thrombosis and pulmonary embolism. Ann Intern Med 1998; 129:1044-1049.
43. van Beek EJ, Reekers JA, Batchelor DA, et al. Feasibility, safety and clinical utility of angiography in patients with suspected pulmonary embolism. Eur Radiol 1996; 6:415-419.
44. Elias A, Colombier D, Victor G, et al. Diagnostic performance of complete lower limb venous ultrasound in patients with clinically suspected acute pulmonary embolism. Thromb Haemost 2004; 91:187-195.