Pulmonary embolism: the role of emergency scan and intervening radiology in medium-high-risk patients with pulmonary embolism

Eleonora Arboscello, Irene Ponassi, Agnese Lomeo, Maria Nives Parodi, Paolo Barbera, Michela Morfino, Nicoletta Pollicardo, Roberto Delfino, Dahane Mhamed, Roberto Tallone
  • Eleonora Arboscello
    Clinica di Medicina Interna 3 - Azienda Ospedaliera Universitaria San Martino di Genova, | lucia.zoppi@pagepress.org
  • Irene Ponassi
    Clinica di Medicina Interna 3 - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Agnese Lomeo
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Maria Nives Parodi
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Paolo Barbera
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Michela Morfino
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Nicoletta Pollicardo
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Roberto Delfino
    Università Operativa di Cardiologia - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Dahane Mhamed
    Radiologia Interventistica - Azienda Ospedaliera Universitaria San Martino di Genova,
  • Roberto Tallone
    Dipartimento di Emergenza - Azienda Ospedaliera Universitaria San Martino di Genova,

Abstract

Pulmonary embolism (PE) is a relative common cardiovascular emergency. Computed tomography (CT) angiography has became the method of choice for suspected PE in routine clinical practice but CT should not be the first-line test for all patients, except suspected high-risk patients and high clinical probability or “PE likely” patients. In these situations emergency phisician ‘s echographic cardiac study can be particularly helpful for a rapid patient management. The two cases prove the helpful use of echografic cardiac study in emergency room and rivet the necessity of an aggressive therapeutic management with primary aim of flow restoration through occluded pulmonary arteries. Percutaneous catheter embolectomy and fragmentation of proximal pulmonary arterial clots may be considerer, with multidisciplinary approach, as an alternative when thrombolysis is absolutely contraindicated or has failed, or as an alternative to surgical treatment.

Keywords

high-risk patients; pulmonary embolism

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Submitted: 2013-02-17 10:36:04
Published: 2010-03-13 00:00:00
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Copyright (c) 2010 Eleonora Arboscello, Irene Ponassi, Agnese Lomeo, Maria Nives Parodi, Paolo Barbera, Michela Morfino, Nicoletta Pollicardo, Roberto Delfino, Dahane Mhamed, Roberto Tallone

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