CHEST
Clinical InvestigationsPrognostic Factors in Medically Treated Patients With Chronic Pulmonary Embolism
Section snippets
Materials and Methods
The study encompassed 53 patients (29 women and 24 men) with CPEwho were hospitalized in the internal medicine and cardiologydepartments of our hospital. The patients were recruited over a periodof 7 years (from January 1991 to October 1997) from our hospital and the departments of internal medicine, pulmonology, and cardiology of several hospitals in the Lower Silesia region.
Pulmonary embolism was recognized in all of the patients byangiography, and phlebography was carried out in all of them.
Results
Thirty-seven of the 49 patients receiving long-termanticoagulation had proximal CPE and 12 had distal CPE. Pulmonaryendarterectomy was not performed in nine patients with proximal CPEbecause of low mean pulmonary artery pressure (mPAP; < 30 mm Hg) with the patients being asymptomatic. The coexistence of distalpulmonary embolism was recognized in seven patients with proximal CPE. The surgical risk was high for 11 patients with proximal CPE (mPAPrange, 46 to 78 mm Hg). The surgical risk was
Discussion
It has been established that after events of acute pulmonaryembolism, most of the emboli resolve spontaneously or in the course of medical treatment. Only a small number of emboli fail to resolvecompletely, resulting in CPE. CTEPH developing after embolization isclinically relevant in approximately 0.01% of CPEpatients.1 The timing of CPE onset after the primaryembolic event is not fully established. A great majority of thromboemboli undergo fibrinolysis in vivo with in 10 to 21days, as shown
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