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Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism.
Australas Radiol 2006; 50(5):424-8AR

Abstract

This is a retrospective study to determine the accuracy and safety of a negative CT pulmonary angiogram (CTPA) based on clinical outcome and to determine the usefulness of a negative D-dimer assay before CTPA. A total of 483 patients with a negative CTPA study were followed up for 3 months, with the aim of detecting episodes of venous thromboembolism and mortality. Three hundred and forty-nine patients had an immunochromatographic D-dimer assay called 'Simplify', carried out before a CTPA examination. Seventy-eight patients had a negative D-dimer assay and a negative CTPA. Three patients had a negative D-dimer assay and a positive CTPA. All three patients had a moderate pretest clinical probability. Of the 483 patients who had a negative CTPA and a 3-month follow up, 444 (92%) were alive and 39 (8%) had died. Of the 444 patients who were alive, none had any further suspected episode of thromboembolism or had received anticoagulation therapy within the follow-up period. Of those who died, none of the deaths was thought to be as a result of pulmonary embolism (PE). Single-detector helical CT can be used safely as the primary diagnostic test to evaluate PE. Negative Simplify D-dimer assay and low pretest clinical probability exclude CTPA-detectable PE, and a CTPA is unnecessary in this cohort of patients.

Authors+Show Affiliations

Department of Radiology, Waikato Clinical School, University of Auckland, Hamilton, New Zealand. rathan67@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16981937

Citation

Subramaniam, R M., et al. "Pulmonary Embolism: Accuracy and Safety of a Negative CT Pulmonary Angiogram and Value of a Negative D-dimer Assay to Exclude CT Pulmonary Angiogram-detectable Pulmonary Embolism." Australasian Radiology, vol. 50, no. 5, 2006, pp. 424-8.
Subramaniam RM, Chou T, Swarbrick M, et al. Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism. Australas Radiol. 2006;50(5):424-8.
Subramaniam, R. M., Chou, T., Swarbrick, M., & Karalus, N. (2006). Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism. Australasian Radiology, 50(5), pp. 424-8.
Subramaniam RM, et al. Pulmonary Embolism: Accuracy and Safety of a Negative CT Pulmonary Angiogram and Value of a Negative D-dimer Assay to Exclude CT Pulmonary Angiogram-detectable Pulmonary Embolism. Australas Radiol. 2006;50(5):424-8. PubMed PMID: 16981937.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pulmonary embolism: accuracy and safety of a negative CT pulmonary angiogram and value of a negative D-dimer assay to exclude CT pulmonary angiogram-detectable pulmonary embolism. AU - Subramaniam,R M, AU - Chou,T, AU - Swarbrick,M, AU - Karalus,N, PY - 2006/9/20/pubmed PY - 2006/12/23/medline PY - 2006/9/20/entrez SP - 424 EP - 8 JF - Australasian radiology JO - Australas Radiol VL - 50 IS - 5 N2 - This is a retrospective study to determine the accuracy and safety of a negative CT pulmonary angiogram (CTPA) based on clinical outcome and to determine the usefulness of a negative D-dimer assay before CTPA. A total of 483 patients with a negative CTPA study were followed up for 3 months, with the aim of detecting episodes of venous thromboembolism and mortality. Three hundred and forty-nine patients had an immunochromatographic D-dimer assay called 'Simplify', carried out before a CTPA examination. Seventy-eight patients had a negative D-dimer assay and a negative CTPA. Three patients had a negative D-dimer assay and a positive CTPA. All three patients had a moderate pretest clinical probability. Of the 483 patients who had a negative CTPA and a 3-month follow up, 444 (92%) were alive and 39 (8%) had died. Of the 444 patients who were alive, none had any further suspected episode of thromboembolism or had received anticoagulation therapy within the follow-up period. Of those who died, none of the deaths was thought to be as a result of pulmonary embolism (PE). Single-detector helical CT can be used safely as the primary diagnostic test to evaluate PE. Negative Simplify D-dimer assay and low pretest clinical probability exclude CTPA-detectable PE, and a CTPA is unnecessary in this cohort of patients. SN - 0004-8461 UR - https://www.unboundmedicine.com/medline/citation/16981937/Pulmonary_embolism:_accuracy_and_safety_of_a_negative_CT_pulmonary_angiogram_and_value_of_a_negative_D_dimer_assay_to_exclude_CT_pulmonary_angiogram_detectable_pulmonary_embolism_ L2 - https://doi.org/10.1111/j.1440-1673.2006.01595.x DB - PRIME DP - Unbound Medicine ER -