Article
Engineering, Biomedical
Dorota Zysko, Konrad Kluwak, Michal Furdal, Przemyslaw Skoczynski, Grzegorz Gogolewski, Goutam Chourasia, Waldemar Banasiak, Dariusz Jagielski, Ryszard Klempous, Jerzy Rozenblit
Summary: This study investigates the use of capnography, a method that monitors CO2 concentration in respiratory gases, for the differential diagnosis of PE. The results suggest that the capnographic curve can be used to predict the occurrence of PE based on the etCO2 values. The study findings provide potential clinical significance for the use of capnography in everyday practice.
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
(2023)
Review
Medicine, General & Internal
Minjun Ma, Yu Li, Xiujuan Xu, Conghua Ji
Summary: The incidence of acute pulmonary embolism (APE) has been increasing annually, and the diagnosis of APE is a challenge for clinicians. This study evaluated multiple diagnostic indicators and found that lung imaging had the highest diagnostic value, followed by D-dimer, Geneva rules, and Wells rules. Clinical trials are recommended to establish an early decision-making model for the diagnosis of pulmonary embolism.
Review
Health Care Sciences & Services
Oana Sirbu, Victorita Sorodoc, Mariana Floria, Cristian Statescu, Radu Sascau, Catalina Lionte, Ovidiu Rusalim Petris, Raluca Ecaterina Haliga, Paula Cristina Morariu, Andreea Tirnoveanu, Vladut Mirel Burduloi, Corina Ursulescu, Laurentiu Sorodoc
Summary: Nontrombotic pulmonary embolism refers to the embolization of different types of materials into pulmonary circulation. Its clinical presentation and laboratory findings are nonspecific, leading to misdiagnosis as pulmonary thromboembolism. Understanding the risk factors and specific symptoms is crucial for rapid and correct diagnosis.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Ilaria Vittoria de Martini, Adrian Raoul Kobe, Christian Roeren, Robert Manka, Andre Euler, Dagmar Keller, Frank Ruschitzka, Hatem Alkadhi, Matthias Eberhard
Summary: This study evaluated the feasibility and accuracy of using CT pulmonary angiography (CTPA) for diagnosing acute heart failure (HF) in emergency department patients. The results showed that both HUratio and HUdiff had a high sensitivity for diagnosing HF, indicating their potential as viable diagnostic markers.
EUROPEAN RADIOLOGY
(2022)
Article
Medicine, General & Internal
Olga Dzikowska-Diduch, Katarzyna Kurnicka, Barbara Lichodziejewska, Olga Zdonczyk, Dominika Dabrowska, Marek Roik, Szymon Pacho, Maksymilian Bielecki, Piotr Pruszczyk
Summary: This study suggests that a Doppler index, TRPG/AcT, improves the assessment of symptomatic pulmonary embolism (PE) survivors. TRPG/AcT > 0.6 indicates a high probability of chronic thromboembolic pulmonary hypertension (CTEPH) or chronic thromboembolic pulmonary disease (CTED), while TRPG/AcT < 0.6 allows for the safe exclusion of CTEPH + CTED in patients with a low echocardiographic probability of pulmonary hypertension (PH).
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Pierre-Yves Le Roux, Pierre-Benoit Bonnefoy, Achraf Bahloul, Benoit Denizot, Bertrand Barres, Caroline Moreau-Triby, Astrid Girma, Amandine Pallardy, Quentin Ceyrat, Laure Sarda-Mantel, Micheline Razzouk-Cadet, Reka Zsigmond, Cachin Florent, Gilles Karcher, Pierre-Yves Salaun
Summary: This study assessed the role of ventilation imaging in COVID-19 patients undergoing lung scintigraphy for suspected pulmonary embolism (PE). The findings showed that in this population, only 57% of patients could confidently exclude PE without ventilation imaging, while 31% of patients required ventilation imaging to rule out PE. The study also revealed a low prevalence of PE (12%).
JOURNAL OF NUCLEAR MEDICINE
(2022)
Review
Medicine, General & Internal
Helia Robert-Ebadi, Thomas Moumneh, Gregoire Le Gal, Marc Righini
Summary: Pulmonary embolism (PE) is a common cause of maternal morbidity and mortality during pregnancy, but diagnosing it in pregnant women is difficult. Two prospective studies have demonstrated the safety of using clinical probability assessment, D-dimer, venous compression ultrasonography, and CT angiography to exclude PE without chest imaging. Implementing these validated diagnostic strategies in clinical practice should be a high priority goal, as pregnant women are at a high risk of inappropriate diagnostic management.
Editorial Material
Medicine, General & Internal
Sanket S. Dhruva, Rita F. Redberg
Summary: Over 500,000 U.S. patients are hospitalized with pulmonary embolism each year, with therapeutic anticoagulation being the standard of care, but adjunctive treatments are sometimes used.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Aaron Shengting Mai, Andrija Matetic, Islam Y. Elgendy, Juan Lopez-Mattei, Rafail A. Kotronias, Louise Y. Sun, Jung Hahn Yong, Rodrigo Bagur, Harriette G. C. Van Spall, Mamas A. Mamas
Summary: This study evaluated the clinical care provided to cancer patients hospitalized for acute pulmonary embolism and assessed the association between type of cancer, in-hospital care, and clinical outcomes. The results showed that cancer patients were less likely to receive invasive management compared to non-cancer patients. Cancer patients had higher odds of mortality, with lung cancer patients having the highest mortality and hemorrhagic stroke risk, while colorectal cancer patients had the highest bleeding risk.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Review
Health Care Sciences & Services
Androniki Gkana, Androniki Papadopoulou, Maria Mermiri, Eleftherios Beltsios, Dimitrios Chatzis, Foteini Malli, Antonis Adamou, Konstantinos Gourgoulianis, Georgios Mavrovounis, Ioannis Pantazopoulos
Summary: This article comprehensively reviews the research progress on novel diagnostic biomarkers for pulmonary embolism (PE), and discusses their application value in daily clinical practice.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Editorial Material
Cardiac & Cardiovascular Systems
Bryan F. Vaca-Cartagena, Candice Y. Lee, Hao A. Tran, Timothy Fernandes, Nick H. Kim, Victor Pretorius
Summary: Heart transplantation is the standard therapy for end-stage heart failure, but patients with submassive pulmonary embolism and heart failure typically need to wait for extended periods of time before being eligible for transplant surgery. In some cases, successful simultaneous pulmonary thromboendarterectomy and heart transplantation have been reported.
ANNALS OF THORACIC SURGERY
(2021)
Article
Health Care Sciences & Services
Masafumi Himeno, Yuji Nagatomo, Akira Miyauchi, Aimi Sakamoto, Keita Kiyose, Midori Yukino-Iwashita, Akane Kawai, Tsukasa Naganuma, Satonori Maekawara, Ayami Naito, Kazuki Kagami, Yusuke Yumita, Risako Yasuda, Takumi Toya, Yukinori Ikegami, Nobuyuki Masaki, Takeshi Adachi
Summary: Venous thromboembolism (VTE) is a common complication in cancer patients, but its clinical presentation and prognosis are not well understood. A retrospective study analyzed 259 patients treated for pulmonary embolism (PE) and found that PE was often incidentally diagnosed among cancer patients and had a lower severity compared to non-cancer patients. Despite lower PE severity, cancer patients had higher D-dimer levels at discharge and poorer prognosis during follow-up. Active malignancy was associated with major adverse cardiovascular events (MACE) and major bleeding. D-dimer at discharge was an independent predictor of mortality, even after adjusting for malignancy.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Yugo Yamashita, Takeshi Morimoto, Kazushige Kadota, Toru Takase, Seiichi Hiramori, Kitae Kim, Maki Oi, Masaharu Akao, Yohei Kobayashi, Mamoru Toyofuku, Moriaki Inoko, Tomohisa Tada, Toshiaki Izumi, Po-Min Chen, Koichiro Murata, Yoshiaki Tsuyuki, Yuji Nishimoto, Tomoki Sasa, Jiro Sakamoto, Minako Kinoshita, Kiyonori Togi, Hiroshi Mabuchi, Kensuke Takabayashi, Takao Kato, Koh Ono, Takeshi Kimura
Summary: A study based on a multicenter registry found that there was no significant difference in the long-term risk of recurrent VTE among patients with different severities of PE at initial diagnosis beyond 3 months, although patients with massive PE were more likely to develop severe recurrent PE events.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2021)
Article
Respiratory System
Gudula J. A. M. Boon, Yvonne M. Ende-Verhaar, Roisin Bavalia, Lahassan H. El Bouazzaoui, Marion Delcroix, Olga Dzikowska-Diduch, Menno Huisman, Katarzyna Kurnicka, Albert T. A. Mairuhu, Saskia Middeldorp, Piotr Pruszczyk, Dieuwertje Ruigrok, Peter Verhamme, Hubert W. Vliegen, Anton Vonk Noordegraaf, Joris W. J. Vriend, Frederikus A. Klok
Summary: The study validated a simple screening strategy for early exclusion of CTEPH after acute PE, reducing the need for echocardiography in the majority of patients and resulting in a substantially shorter diagnostic delay compared to current practice.
Review
Infectious Diseases
Lorenzo Vittorio Rindi, Samir Al Moghazi, Davide Roberto Donno, Maria Adriana Cataldo, Nicola Petrosillo
Summary: This systematic review summarizes the literature on prediction rules for pulmonary embolism in hospitalized COVID-19 patients. The study found the need for new prediction rules that take into account patient-specific factors to better assess the risk.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Review
Hematology
Faizan Khan, Alvi Rahman, Tobias Tritschler, Marc Carrier, Clive Kearon, Jeffrey Weitz, Sam Schulman, Francis Couturaud, Cecilia Becattini, Giancarlo Agnelli, Timothy A. Brighton, Anthonie W. A. Lensing, Laurent Pinede, Sameer Parpia, Geert-Jan Geersing, Toshihiko Takada, Charlotte A. Bradbury, Giuseppe M. Andreozzi, Gualtiero Palareti, Paolo Prandoni, Harry R. Buller, Ranjeeta Mallick, Brian Hutton, Kednapa Thavorn, Gregoire Le Gal, Marc A. Rodger, Dean A. Fergusson
Summary: The risk of major bleeding after discontinuing anticoagulant therapy for a first unprovoked venous thromboembolism is not zero, and a portion of these bleeding events may be fatal.
THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Emergency Medicine
T. Moumneh, A. Penaloza, A. Armand, H. Robert-Ebadi, M. Righini, D. Douillet, G. Le Gal, P. -M. Roy
Summary: The management of suspected pulmonary embolism in pregnant women in the emergency department raises numerous issues. The physiological changes during pregnancy increase the number of emergency visits for symptoms such as chest pain, dyspnea, and faintness, which may interfere with the assessment of pulmonary embolism probability. The elevated D-dimers and inconclusive chest imaging further complicate the diagnostic pathway. However, it is crucial not to miss a diagnosis of pulmonary embolism during pregnancy while minimizing unnecessary exposure to chest imaging for the patient and her fetus. Two validated strategies have been developed for decision making in pregnant women. The first strategy is based on the Geneva score, which includes performing a proximal compression ultrasound in patients with high probability or a D-dimer level greater than 500 ng/mL. The second strategy is based on the YEARS algorithm, with ultrasound performed only in patients with symptoms suggestive of associated lower limb venous thrombosis, followed by D-dimer testing with a threshold of 500 or 1,000 ng/mL based on clinical probability. The safety of both strategies has been demonstrated. The advantage of the first strategy lies in its reliance on objective data, while the second strategy benefits from using a decision threshold of 1,000 ng/mL in patients without any of the YEARS criteria.
ANNALES FRANCAISES DE MEDECINE D URGENCE
(2022)
Review
Radiology, Nuclear Medicine & Medical Imaging
Stephanie Tan, John W. Nance, Linda B. Haramati, Prabhakar Rajiah, William M. Sherk, Gregoire Le Gal, Jadranka Stojanovska
Summary: This article discusses the purpose, optimal format, and relevant findings of the radiology report for pulmonary CTA.
AMERICAN JOURNAL OF ROENTGENOLOGY
(2022)
Letter
Medicine, General & Internal
Marc Carrier, Gregoire Le Gal
ANNALS OF INTERNAL MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Tobias Tritschler, Gregoire Le Gal, Shari Brosnahan, Marc Carrier
Article
Hematology
Marc Righini, Helia Robert-Ebadi, Alessio Cremonesi, Antoine Elias, Olivier Sanchez, Emmanuelle Le Moigne, Jeannot Schmidt, Catherine Le Gall, Jacques Cornuz, Drahomir Aujesky, Pierre-Marie Roy, Celine Chauleur, Frederic Rouyer, Pierre-Alexandre Poletti, Caroline Moreau, Gregoire Le Gal
Summary: No cases of neonatal hypothyroidism were identified among 149 pregnant women investigated for suspected pulmonary embolism using CTPA, providing further reassurance regarding the safety of CTPA in this indication.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Stephanie Tan, Linda B. Hamarati, Prabhakar S. Rajiah, Gregoire Le Gal, Jane P. Ko, Jadranka Stojanovska
Summary: This article reviews the different steps and methods for assessing thromboembolic disease using pulmonary CTA. It provides updates on commonly used clinical decision tools, specific parameter adjustments for challenging patients, and potential improvements in radiology research. Radiologists play an important role in improving the quality of assessment.
SEMINARS IN ROENTGENOLOGY
(2022)
Article
Medicine, General & Internal
Rebecca C. Auer, Michael Ott, Paul Karanicolas, Muriel Rebecca Brackstone, Shady Ashamalla, Joel Weaver, Vicky Tagalakis, Marylise Boutros, Peter Stotland, Antonio Caycedo Marulanda, Husein Moloo, Shiva Jayaraman, Suni Patel, Gregoire Le Gal, Silvana Spadafora, Steven MacLellan, Daniel Trottier, Derek Jonker, Timothy Asmis, Ranjeeta Mallick, Amanda Pecarskie, Tim Ramsay, Marc Carrier
Summary: This study aimed to evaluate the efficacy and safety of extended perioperative thromboprophylaxis with low molecular weight heparin in patients undergoing resection for colorectal cancer. The study found that extended duration thromboprophylaxis did not improve disease-free survival or overall survival in these patients compared to in-patient postoperative thromboprophylaxis alone. The incidences of venous thromboembolism and postoperative major bleeding were low and similar between groups.
BMJ-BRITISH MEDICAL JOURNAL
(2022)
Meeting Abstract
Hematology
Vicky Mai, Emily S. L. Martens, Marc Righini, Sam Schulman, Venkatesh Thiruganasambandamoorthy, Susan Kahn, Veronica Bates, Amanda Pecarskie, Michael J. Kovacs, Shaun Visser, Sudeep P. Shivakumar, Melanie Tan, Marc A. Rodger, Dimitrios Scarvelis, Aurelien Delluc, Philippe Girard, Menno Huisman, Philip S. Wells, Frederikus A. Klok, Gregoire Le Gal
Meeting Abstract
Hematology
Faizan Khan, Doug Coyle, Kednapa Thavorn, Sasha van Katwyk, Tobias Tritschler, Brian Hutton, Gregoire Le Gal, Marc A. Rodger, Dean Fergusson
Article
Medicine, General & Internal
Faizan Khan, Kednapa Thavorn, Doug Coyle, Sasha van Katwyk, Tobias Tritschler, Brian Hutton, Gregoire Le Gal, Marc Rodger, Dean Fergusson
Summary: This study aims to assess the differences in clinical benefits, harms, and costs of stopping versus continuing anticoagulant therapy indefinitely for a first unprovoked venous thromboembolism (VTE). A probabilistic Markov model will be developed to estimate life-years, quality-adjusted life-years, costs, and incremental cost-effectiveness ratios. The results will be disseminated through conferences and a peer-reviewed journal.
Article
Hematology
Helia Robert-Ebadi, Pierre-Marie Roy, Olivier Sanchez, Frank Verschuren, Gregoire Le Gal, Marc Righini
Summary: The study validates a new diagnostic strategy for suspected pulmonary embolism, aiming to reduce the use of CTPA. The PEGeD algorithm can exclude the possibility of PE based on low and moderate clinical pretest probabilities, combined with D-dimer levels. The study demonstrates the external validation of the PEGeD algorithm in an independent cohort.
Article
Hematology
Jan O. Gaugler, Marc Righini, Helia Robert-Ebadi, Olivier Sanchez, Pierre-Marie Roy, Franck Verschuren, Sebastien Miranda, Aurelien Delluc, Gregoire Le Gal, Tobias Tritschler
Summary: This study evaluated the association between obesity and body mass index (BMI) with confirmed pulmonary embolism (PE) in patients with suspected PE and assessed the efficiency and safety of the age-adjusted D-dimer strategy in obese patients. The results showed that BMI and obesity were not associated with confirmed PE. The use of the age-adjusted D-dimer strategy increased the proportion of obese patients in whom PE was considered ruled out without imaging.
THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Oncology
Fanny Pinot, David Bourhis, Vincent Bourbonne, Romain Floch, Maelle Mauguen, Frederique Blanc-Beguin, Ulrike Schick, Mohamed Hamya, Ronan Abgral, Gregoire Le Gal, Pierre-Yves Salaun, Francois Lucia, Pierre-Yves Le Roux
Summary: This study aimed to develop and evaluate an automated threshold method based on total lung function for the delineation of lung functional volumes using Gallium-68 MAA lung PET/CT imaging. The results showed that the WLF threshold method provided more reliable and consistent functional volumes, especially in patients with normal PFTs, as compared to the pmax method. This new approach, relatively unaffected by the presence of hot spots, is clinically meaningful for clinicians.
Article
Medicine, General & Internal
Raphael Degrave, Juliette Murris, Anais Charles-Nelson, Olivier Hermine, Raphael Porcher, Philippe Ravaud, Xavier Mariette, Pierre-Louis Tharaux, Matthieu Resche-Rigon, Olivier Sanchez, Sandrine Katsahian, Jean-Benoit Arlet
Summary: This study found that diabetes and high CRP level were risk factors for arterial and venous thromboses in COVID-19 pneumonia patients hospitalized in general wards. Obesity was not associated with a higher risk of thrombosis. Higher doses of anticoagulants could be considered in these high-risk patients, opening up opportunities for interventional studies.
POSTGRADUATE MEDICAL JOURNAL
(2023)
