Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr;54(4):626-631.
doi: 10.1111/imj.16249. Epub 2023 Oct 23.

Incidental central pulmonary emboli in outpatients with deep vein thrombosis

Christopher J Troupis  1 , Jordan S Berman  2 , Gary Hammerschlag  3 , Anthony J Upton  4 , Alexander N Rhodes  5
Affiliations

Incidental central pulmonary emboli in outpatients with deep vein thrombosis

Christopher J Troupis et al. Intern Med J. 2024 Apr.

Abstract

Background: While it has been demonstrated that large asymptomatic pulmonary embolism (PE) can occur, many studies have assessed inpatients or patients with known risk factors for venous thromboembolism (such as malignancy). There are few data regarding incidental PE in outpatients with deep vein thrombosis (DVT) or assessing whether these emboli occur centrally or peripherally in the pulmonary arteries.

Aims: To determine the rates of incidental central and peripheral PE in outpatients with proximal and distal DVT.

Methods: This was a retrospective cross-sectional study of 120 patients attending our community imaging clinic between January 2015 and March 2020, with ultrasound-confirmed lower limb DVT, and subsequent computed tomography pulmonary angiogram (CTPA) within 24 h. Exclusion criteria were symptoms indicative of PE. Imaging reports were retrospectively reviewed to record the proximity of DVT and the location of any PE as either central (pulmonary trunk or main pulmonary arteries) or peripheral (lobar, segmental or subsegmental pulmonary arteries).

Results: Incidental PE occurred in 71 patients (59.2%), with a rate of 77.5% in proximal and 50.0% in distal DVT. Sixteen patients had central PE (13.3% of all patients with DVT; 22.5% of all patients with PE). Two patients (both with proximal DVT) had PE in the pulmonary trunk.

Conclusions: Incidental PE occur frequently in outpatients with lower limb DVT, including the possibility of asymptomatic central emboli. Further studies with larger patient cohorts would be useful to assess the utility of baseline chest imaging in outpatients with DVT.

Keywords: asymptomatic diseases; computed tomography angiography; pulmonary embolism; venous thromboembolism; venous thrombosis.

PubMed Disclaimer

References

    1. Jha AK, Larizgoitia I, Audera‐Lopez C, Prasopa‐Plaizier N, Waters H, Bates DW. The global burden of unsafe medical care: analytic modelling of observational studies. BMJ Qual Saf 2013; 22: 809.
    1. Dorfman GS, Cronan JJ, Tupper TB, Messersmith RN, Denny DF, Lee CH. Occult pulmonary embolism: a common occurrence in deep venous thrombosis. Am J Roentgenol 1987; 148: 263–266.
    1. Stein PD, Matta F, Musani MH, Diaczok B. Silent pulmonary embolism in patients with deep venous thrombosis: a systematic review. Am J Med 2010; 123: 426–431.
    1. Khorana AA, O'Connell C, Liebman HA, Agnelli G, Lee AYY. Incidental venous thromboembolism in oncology patients. J Thromb Haemost 2012; 10: 2602–2604.
    1. Aramberri M, Benegas M, Sanchez M, Munoz‐Guglielmetti D, Zamora C, Garcia‐Villa A et al. Saddle pulmonary embolism in patients with cancer in the era of incidental events: clinical findings and outcomes in a single Centre cohort. TH Open 2022; 6: e267–e275.

LinkOut - more resources