Combined Helical Computed Tomographic Pulmonary Angiography and Lung Perfusion Scintigraphy for Investigating Acute Pulmonary Embolism

2002 ◽  
Vol 57 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Helen T.H. Wilson ◽  
Tom M.M. Meagher ◽  
Steve J. Williams
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Lung Perfusion ◽  
Perfusion Scintigraphy ◽  
Lung Perfusion Scintigraphy ◽  
Computed Tomographic ◽  
Computed Tomographic Pulmonary Angiography

scholarly journals Healthcare and Economic Impact of Lung Perfusion Scintigraphy in Patients Affected by Acute Pulmonary Embolism

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 716
Author(s):  
Giuseppe Rubini ◽  
Cristina Ferrari ◽  
Paolo Mammucci ◽  
Antonio Pisani ◽  
Pierpaolo Mincarone ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Lung Perfusion ◽  
Perfusion Scintigraphy ◽  
Lung Perfusion Scintigraphy ◽  
Assessment And Treatment ◽  
Risk Patients ◽  
Direct Healthcare Costs ◽  
Healthcare Processes

Acute pulmonary embolism (APE) is a cardiovascular emergency, representing the main cause of mortality, morbidity, and hospitalisation in Europe. We aim to evaluate the economic and healthcare impact of lung perfusion scintigraphy (LPS) used in patients with suspected APE, in the event of non-conclusive or contraindicated computed tomography pulmonary angiography (CTPA). We considered two alternative healthcare processes for APE diagnosis, with and without LPS. We performed a cost analysis with the aim of evaluating the average direct healthcare costs for diagnosis, risk assessment, and treatment of APE. We used data from a monocentric trial. Our economic model showed that the strategy with LPS was preferable in terms of costs. The average per-patient costs for the diagnosis and treatment of the acute phase of PE in low-risk patients with a non-conclusive or not-executable CTPA, with and without LPS, are EUR 2145.25 and EUR 4912.45, respectively. LPS is a simple, quick, and economic examination, useful in this setting of patients not only for an early diagnosis but also to exclude APE, demonstrating an advantage in terms of healthcare resources. To the best of our knowledge, this study is the first to analyse the economic and healthcare impact of the use of LPS in the diagnostic pathway of suspected APE.

scholarly journals Right-to-left Ventricular Diameter Ratio At Computed Tomographic Pulmonary Angiography in Patients with Acute Pulmonary Embolism and Obstructive Sleep Apnea

2020 ◽  
Vol 14 ◽  
pp. 117954842097643
Author(s):  
Thomas M Berghaus ◽  
Fabian Geissenberger ◽  
Dinah Konnerth ◽  
Michael Probst ◽  
Thomas Kröncke ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Obstructive Sleep Apnea ◽  
Acute Pulmonary Embolism ◽  
Pulmonary Angiography ◽  
Left Ventricular ◽  
Diameter Ratio ◽  
Computed Tomographic ◽  
Obstructive Sleep ◽  
Computed Tomographic Pulmonary Angiography ◽  
Acute Pe

Purpose: Right ventricular (RV) dysfunction in acute pulmonary embolism (PE) is a critical determinant of outcome. Obstructive sleep apnea (OSA) is a common comorbidity of PE and might also affect RV function. Therefore, we sought to investigate RV dysfunction in PE patients in proportion to the severity of OSA by evaluating the right-to-left ventricular (RV/LV) diameter ratio on computed tomographic pulmonary angiography (CTPA). Materials and Methods: 197 PE patients were evaluated for sleep-disordered breathing by portable monitoring and nocturnal polysomnography. RV dilatation was defined as an RV/LV diameter ratio of ⩾ 1.0. Results: RV dilatation was significantly more frequent in OSA patients compared to study participants without OSA (66.4% vs 49.1%, P = .036). Elevated troponin I values, indicating myocardial injury due to acute, PE-related RV strain, were significantly more frequent in OSA patients with an apnea-hypopnea index (AHI) ⩾ 15/h compared to those with an AHI < 15/h (62.1% vs 45.8%, P = .035). However, RV dysfunction documented by the RV/LV diameter ratio on CTPA was not significantly associated with the severity of OSA in multivariable regression analysis. Conclusion: Patients with moderate or severe OSA might compensate acute, PE-related RV strain better, as they are adapted to repetitive right heart pressure overloads during sleep.

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