Abstract Number: PB2275
Meeting: ISTH 2020 Congress
Background: The true incidence of isolated subsegmental pulmonary embolism (ISSPE), either incidental or symptomatic, as well as its clinical importance and the best treatment, if any, are still unclear.
Aims: To assess the incidence and clinical outcome of symptomatic ISSPE.
Methods: from Jan 2016 to Jan 2019 we selected consecutive symptomatic patients for suspected PE who underwent a multidector row computed tomography pulmonary angiography (CTPA). In order to identify the patients with an ISSPE two blinded thoracic radiologists reviewed the images independently. In case of disagreement, the opinion of a third radiologist was obtained. In patients with confirmed ISSPE, clinical characteristics at diagnosis, type and duration of anticoagulant therapy, VTE recurrences, bleeding episodes and VTE-related mortality within 6 months after the diagnosis were collected. Results are expressed as mean ± standard deviation. Data were analyzed using chi-squared test or Fisher’s exact test, when appropriate.
Results: Among 4052 suspected symptomatic PE, ISSPE were confirmed in 92 patients, with an overall incidence of 8.4%/years, that increase from 6.8% to 11,8%/years in the last period. 82 (89.2%) patients received an anticoagulant treatment, which was prolonged to at least 6 months in 47% of them. 10 patients (10.2%) were left untreated. After six months a VTE-related event occur in 13 (14.1%) patients. Among these, a VTE-related event occurred in 12 patients treated with anticoagulants (table 1) and in 1 patients left untreated. No recurrent VTE episode was observed in the cohort, while 6 six major bleeding (2 fatal) developed in the treated patients.
Conclusions: Symptomatic ISSPE is diagnosed in a not negligible proportion of patients. While the risk of VTE recurrence seems low even in ISSPE untreated patients, the incidence of VTE-related major adverse events is mainly due to bleeding during anticoagulation. Large prospective studies are needed to establish the optimal duration of anticoagulant therapy in symptomatic ISSPE patients.
To cite this abstract in AMA style:Ceccato D, De Conti G, Motta R, Pesavento R. Outcome of the Symptomatic Subsegmental Isolated Pulmonary Embolism: The SSPE Padua Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/outcome-of-the-symptomatic-subsegmental-isolated-pulmonary-embolism-the-sspe-padua-study/. Accessed November 29, 2023.
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