With the development of new methods for detecting pulmonary embolism, the need for angiography has been greatly reduced. Dr. Perrier is an attending physician, Medical Clinic 1, Department of Medicine, Geneva University Hospital, Geneva, Switzerland.
Pulmonary embolism is a frequent and potentially fatal disorder.
In the United States, it is responsible for about 2.3 new cases per 10,000 persons and 50,000 deaths every year. The recent development of noninvasive methods for detecting pulmonary embolism has relieved much of the diagnostic dilemma. Moreover, a strategy for combining these instruments has been clinically validated and found to be cost-effective. As illustrated in the following cases, these new methods have radically changed the approach to patients suspected of having nonmassive pulmonary embolism. Massive pulmonary embolism continues to be a specific diagnostic and therapeutic problem and is not included in the present discussion.