Special Considerations in Pulmonary Embolism Clot-in-Transit and Incidental Pulmonary Embolism

被引:11
作者
Kabrhel, Christopher [1 ]
Rosovsky, Rachel [2 ]
Garvey, Shannon [3 ]
机构
[1] Harvard Med Sch, Ctr Vasc Emergencies, Massachusetts Gen Hosp, Dept Emergency Med, Zero Emerson Pl,Suite 3B, Boston, MA 02114 USA
[2] Massachusetts Gen Hosp, Dept Med, Div Hematol, 55 Fruit St, Boston, MA 02114 USA
[3] Boston Univ, Sch Med, 72 E Concord St, Boston, MA 02118 USA
关键词
Pulmonary embolism; Clot-in-transit; Venous thromboembolism; RIGHT-HEART THROMBI; TISSUE-PLASMINOGEN ACTIVATOR; RIGHT ATRIAL THROMBUS; PROGNOSTIC-SIGNIFICANCE; VENOUS THROMBOEMBOLISM; FLOATING THROMBUS; ANTITHROMBOTIC THERAPY; EXTENDED TREATMENT; AMERICAN-COLLEGE; CANCER-PATIENTS;
D O I
10.1016/j.ccc.2020.02.008
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
This article describes 2 relatively rare, but complex situations in pulmonary embolism (PE): clot-in-transit (CIT), incidental PE (IPE). CIT describes a venous thromboembolism that has become lodged in the right heart. CIT is associated with high mortality and presents unique challenges in management. Incidental PE (IPE) describes PE diagnosed on imaging performed for another indication. The treatment is complex because there is often a disconnect between the PE severity on imaging and lack of severity of the clinical presentation. We summarize the available literature and aid clinicians as they manage patients with PE across the clinical severity spectrum.
引用
收藏
页码:531 / +
页数:17
相关论文
共 74 条
  • [1] Large embolus in transit - An unresolved therapeutic dilemma (case report and review of literature)
    Agarwal, Vratika
    Nalluri, Nikhil
    Shariff, Masood A.
    Akhtar, Muhammad S.
    Olkovsky, Yefim
    Kitsis, Paul E.
    Nabagiez, John P.
    [J]. HEART & LUNG, 2014, 43 (02): : 152 - 154
  • [2] Apixaban for Extended Treatment of Venous Thromboembolism
    Agnelli, Giancarlo
    Buller, Harry R.
    Cohen, Alexander
    Curto, Madelyn
    Gallus, Alexander S.
    Johnson, Margot
    Porcari, Anthony
    Raskob, Gary E.
    Weitz, Jeffrey I.
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2013, 368 (08) : 699 - 708
  • [3] Management of right heart thrombi associated with acute pulmonary embolism: a retrospective, single-center experience
    Akilli, Hakan
    Gul, Enes Elvin
    Aribas, Alpay
    Ozdemir, Kurtulus
    Kayrak, Mehmet
    Erdogan, Halil Ibrahim
    [J]. ANADOLU KARDIYOLOJI DERGISI-THE ANATOLIAN JOURNAL OF CARDIOLOGY, 2013, 13 (06): : 528 - 533
  • [4] SHOCK-INDEX
    ALLGOWER, M
    BURRI, C
    [J]. DEUTSCHE MEDIZINISCHE WOCHENSCHRIFT, 1967, 92 (43) : 1947 - &
  • [5] Comparative efficacy of different modalities for treatment of right heart thrombi in transit: A pooled analysis
    Athappan, Ganesh
    Sengodan, Prasanna
    Chacko, Paul
    Gandhi, Sanjay
    [J]. VASCULAR MEDICINE, 2015, 20 (02) : 131 - 138
  • [6] Virchow and his triad: a question of attribution
    Bagot, Catherine N.
    Arya, Roopen
    [J]. BRITISH JOURNAL OF HAEMATOLOGY, 2008, 143 (02) : 180 - 190
  • [7] Prognostic Significance of Right Heart Thrombi in Patients With Acute Symptomatic Pulmonary Embolism
    Barrios, Deisy
    Rosa-Salazar, Vladimir
    Morillo, Raquel
    Nieto, Rosa
    Fernandez, Sara
    Zamorano, Jose Luis
    Monreal, Manuel
    Torbicki, Adam
    Yusen, Roger D.
    Jimenez, David
    [J]. CHEST, 2017, 151 (02) : 409 - 416
  • [8] Right heart thrombi in pulmonary embolism
    Barrios, Deisy
    Rosa-Salazar, Vladimir
    Jimenez, David
    Morillo, Raquel
    Muriel, Alfonso
    del Toro, Jorge
    Lopez-Jimenez, Luciano
    Farge-Bancel, Dominique
    Yusen, Roger
    Monreal, Manuel
    [J]. EUROPEAN RESPIRATORY JOURNAL, 2016, 48 (05) : 1377 - 1385
  • [9] BARRITT DW, 1960, LANCET, V1, P1309
  • [10] Right atrial thrombi: Percutaneous mechanical thrombectomy
    Beregi, JP
    Aumegeat, V
    Loubeyre, C
    Coullet, JM
    Asseman, P
    DebackerSteckelorom, C
    Bauchart, JJ
    Liu, PC
    Thery, C
    [J]. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 1997, 20 (02) : 142 - 145