The Resolution Rate of Pulmonary Embolism on CT Pulmonary Angiography: a Prospective Study

Abstract

<h3>Purpose</h3><p>To prospectively assess the rate of clot resolution from <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/computed-tomography" title="Learn more about CT from ScienceDirect's AI-generated Topic Pages">CT</a> <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/pulmonary-angiography" title="Learn more about pulmonary angiography from ScienceDirect's AI-generated Topic Pages">pulmonary angiography</a> (CTPA) in <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/patient" title="Learn more about patients from ScienceDirect's AI-generated Topic Pages">patients</a> with <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/acute-pulmonary-embolism" title="Learn more about acute pulmonary embolism from ScienceDirect's AI-generated Topic Pages">acute pulmonary embolism</a> (PE).</p><h3>Materials and Methods</h3><p>This <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/prospective-cohort-study" title="Learn more about prospective cohort study from ScienceDirect's AI-generated Topic Pages">prospective cohort study</a> included 290 <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/patient" title="Learn more about patients from ScienceDirect's AI-generated Topic Pages">patients</a> (136 men, 154 women; mean age, 51.9 years) with acute PE. All patients had a CTPA at the presentation and had at least one follow-up within 6 months (mean 72.7 days). Sixty-four percent of patients had follow-up scans for research purposes within a pre-determined period (between 28 and 184 days; mean, 78.27 days) and 36 % had (between 2 and 184 days; mean, 62.78 days) for a clinical indication. The volume of each clot was measured using a semi-automated quantification program. The resolution rate was evaluated by interval-censored analysis.</p><h3>Results</h3><p>The overall estimated probability of complete resolution was 42 % at 7 days, 56 % <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/dihydrotachysterol" title="Learn more about at 10 from ScienceDirect's AI-generated Topic Pages">at 10</a> days, and 71 % at 45 days. Achieving complete resolution was significantly faster <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/inpatient" title="Learn more about in patients from ScienceDirect's AI-generated Topic Pages">in patients</a> with peripheral clots (HR: 1.78; CI: 1.05–3.03, p = 0.032) but slower <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/inpatient" title="Learn more about in patients from ScienceDirect's AI-generated Topic Pages">in patients</a> with consolidation and history of <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/venous-thromboembolism" title="Learn more about venous thromboembolism from ScienceDirect's AI-generated Topic Pages">venous thromboembolism</a> (VTE), (HR: 0.37; CI: 0.18–0.79, p = 0.01 and HR: 0.57; CI: 0.35–0.91, p = 0.019, respectively). Although the patients with cancer showed a faster resolution rate (HR: 1.67; CI: 1.05–2.68, p = 0.032), the mortality rate was significantly higher than non-cancer patients.</p><h3>Conclusion</h3><p>The resolution rate of clot burden in acute PE was associated with patients' clinical presentation variables and CTPA imaging biomarkers. This information may be incorporated into designing a prediction rule and determining the appropriate duration of <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/anticoagulant-therapy" title="Learn more about anticoagulation therapy from ScienceDirect's AI-generated Topic Pages">anticoagulation therapy</a> in patients with acute PE.</p>