The impact of saddle embolism on the major adverse event rate of patients with non-high-risk pulmonary embolism

• Published in: British journal of radiology 2013-12, Vol.86 (1032), p.20130273
• Main Authors: Kwak, M K, Kim, W Y, Lee, C W, Seo, D W, Sohn, C H, Ahn, S, Lim, K S, Donnino, M W
• Format: Article
• Language: English
• Subjects: Aged; Angiography - methods; Female; Humans; Male; Middle Aged; Prognosis; Pulmonary Artery - diagnostic imaging; Pulmonary Embolism - complications; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - mortality; Retrospective Studies; Risk Assessment; Risk Factors; Survival Rate; Tomography, X-Ray Computed - methods
• ISSN: 0007-1285; 1748-880X; 1748-880X
• DOI: 10.1259/bjr.20130273

Wider application of CT angiography (CTA) improves the diagnosis of acute pulmonary embolism (PE). It also permits the visualisation of saddle embolism (SE), namely thrombi, which are located at the bifurcation of the main pulmonary artery. The aim of this study was to assess the prevalence of SE and whether SE predicts a complicated clinical course in patients with non-high-risk PE. In total, 297 consecutive patients with non-high-risk PE confirmed using CTA in the emergency department were studied. The presence of SE and its ability to predict the occurrence of major adverse events (MAEs) within 1 month were determined. Of the 297 patients, 27 (9.1%) had an SE. The overall mortality at 1 month was 12.5%; no significant difference was observed between the SE and non-SE groups (18.5% vs 11.9%, p=0.32). However, patients with SE were more likely to receive thrombolytic therapy (29.6% vs 8.1%, p