Lisette van Dam

CTPP and 3-months clinical outcomes after acute PE 11 173 (1.1%) was diagnosed with deep vein thrombosis of the leg and recurrent VTE was excluded in the other 5 patients. A total of 6 patients (6.5%) died during the follow- up period, of whom 2 patients as result of the index PE. PDS was not correlated to persistent dyspnea (mean difference -3.7%; 95%CI -9.7% to 2.3%), chest pain (mean difference -0.70%; 95%CI -8.7% to 7.3%) or post- PE functional impairment (mean difference -4.7%; 95%CI -11% to 1.3%, Table 1 ). Moreover, CTPP-assessed PDS could not predict PE-related readmission (mean difference of 3.3%; 95%CI -5.4% to 12%) or all-cause mortality (mean difference 0.1%; 95%CI -10% to 11%, Table 1 ). Table 1. Perfusion defect score (PDS) in 93 acute pulmonary embolism (PE) patients and its correlation with persistent symptoms and adverse outcome at 3-month follow-up Prevalence (%) Mean (SD) PDS in % in patients with: Mean (SD) PDS in % in patients without: Mean difference (95% CI) Persistent symptoms at 3 months Dyspnea 22 (24) 24 (11) 28 (13) -3.7 (-9.7 to 2.3) Chest pain 11 (12) 26 (11) 27 (13) -0.70 (-8.7 to 7.3) Post-PE functional impairment 22 (24) 23 (11) 28 (13) -4.7 (-11 to 1.3) Adverse outcomes at 3 months Recurrent VTE 1 (1.1) 30 (-) 27 (13) 3 (-) PE-related readmission 9 (9.7) 31 (12) 27 (12) 3.3 (-5.4 to 12) All-cause mortality 6 (6.5) 27 (21) 27 (12) 0.1 (-10 to 11) DISCUSSION In this analysis, we did not find clinically relevant correlations between PDS at initial PE diagnosis and persistent symptoms nor between PDS and any of the evaluated adverse outcomes at 3-month follow-up. Multiple studies have shown that incomplete thrombus resolution occurs in around 50% of patients after acute PE episode despite adequate anticoagulant treatment. 3,4,6 At least two studies have demonstrated that pulmonary vascular obstruction (PVO) on initial CTPA and ventilation/perfusion scan (V/Q scan) were