Risk of asymptomatic pulmonary embolism in patients with deep venous thrombosis

Mariana Krutman; Nelson Wolosker; Sérgio Kuzniec; João Carlos de Campos Guerra; Adriano Tachibana; Cynthia de Almeida Mendes

doi:10.1016/j.jvsv.2013.04.002

Risk of asymptomatic pulmonary embolism in patients with deep venous thrombosis

J Vasc Surg Venous Lymphat Disord. 2013 Oct;1(4):370-5. doi: 10.1016/j.jvsv.2013.04.002. Epub 2013 Jul 3.

Authors

Mariana Krutman¹, Nelson Wolosker², Sérgio Kuzniec³, João Carlos de Campos Guerra⁴, Adriano Tachibana⁵, Cynthia de Almeida Mendes³

Affiliations

¹ Department of Vascular and Endovascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: [email protected].
² Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil; Division of Vascular Surgery, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
³ Department of Vascular Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.
⁴ Department of Clinical Pathology, Hospital Israelita Albert Einstein, São Paulo, Brazil.
⁵ Department of Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.

PMID: 26992758
DOI: 10.1016/j.jvsv.2013.04.002

Abstract

Objective: The aim of our study is to evaluate the incidence of asymptomatic pulmonary embolism (PE) in patients with deep venous thrombosis (DVT), submitted to routine angiography of pulmonary vessels, and analyze the relationship between the site of DVT and extent of PE.

Methods: Between January 2006 and April 2012, 52 consecutive patients with acute inferior limb DVT were divided into two study groups composed of individuals with proximal and distal thrombotic involvement. All patients had no respiratory symptoms and were submitted to routine pulmonary computed tomography angiography for active investigation of PE. We assessed the incidence and extent of PE in both study groups.

Results: Thirty-eight patients (72%) had PE, detected by computed tomography angiography. The incidence of PE in patients with proximal and distal thrombosis, respectively, was 72.7% and 73.7%. Occurrence of segmental embolism was equally high in both groups, affecting 71.4% of the patients with distal thrombosis and 66.6% of the individuals with proximal DVT (P > .99).

Conclusions: The incidence of asymptomatic PE observed in patients with DVT is higher than what is reported in the current literature. This supports the importance of screening and the need for high levels of suspicion regarding this complication.