Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism
Authors: Philippe Girard
Journal: Annals of Internal Medicine (2005)

Letters3 May 2005Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary EmbolismPhilippe Girard, MDPhilippe Girard, MDFrom Institut Mutualiste Montsouris, 75014 Paris, France.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-9-200505030-00026 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their careful and commendable meta-analysis of outcome studies that used CTPA in patients with suspected PE, Moores and colleagues (1) concluded that “it appears to be safe to withhold anticoagulation after negative CTPA results.” I believe that such a message goes beyond the conclusions that can be drawn from the authors' data.As Moores and colleagues acknowledged, among the 23 outcome studies they analyzed, only 1 used CTPA as the sole diagnostic test. Furthermore, in the 3 largest prospective studies (at least 350 patients in each study remained untreated), anticoagulation was withheld only when both CTPA ...References1. Moores LK, Jackson WL, Shorr AF, Jackson JL. Meta-analysis: outcomes in patients with suspected pulmonary embolism managed with computed tomographic pulmonary angiography. Ann Intern Med. 2004;141:866-74. [PMID: 15583229] LinkGoogle Scholar2. Musset D, Parent F, Meyer G, Maitre S, Girard P, Leroyer C, et al. Diagnostic strategy for patients with suspected pulmonary embolism: a prospective multicentre outcome study. Lancet. 2002;360:1914-20. [PMID: 12493257] CrossrefMedlineGoogle Scholar3. Perrier A, Roy PM, Aujesky D, Chagnon I, Howarth N, Gourdier AL, et al. Diagnosing pulmonary embolism in outpatients with clinical assessment, D-dimer measurement, venous ultrasound, and helical computed tomography: a multicenter management study. Am J Med. 2004;116:291-9. [PMID: 14984813] CrossrefMedlineGoogle Scholar4. van Strijen MJ, de Monye W, Schiereck J, Kieft GJ, Prins MH, Huisman MV, et al. Single-detector helical computed tomography as the primary diagnostic test in suspected pulmonary embolism: a multicenter clinical management study of 510 patients. Ann Intern Med. 2003;138:307-14. [PMID: 12585828] LinkGoogle Scholar5. Perrier A, Howarth N, Didier D, Loubeyre P, Unger PF, de Moerloose P, et al. Performance of helical computed tomography in unselected outpatients with suspected pulmonary embolism. Ann Intern Med. 2001;135:88-97. [PMID: 11453707] LinkGoogle Scholar6. Bourriot K, Couffinhal T, Bernard V, Montaudon M, Bonnet J, Laurent F. Clinical outcome after a negative spiral CT pulmonary angiographic finding in an inpatient population from cardiology and pneumology wards. Chest. 2003;123:359-65. [PMID: 12576352] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Institut Mutualiste Montsouris, 75014 Paris, France.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPerformance of Helical Computed Tomography in Unselected Outpatients with Suspected Pulmonary Embolism Arnaud Perrier , Nigel Howarth , Dominique Didier , Pierre Loubeyre , Pierre-François Unger , Philippe de Moerloose , Daniel Slosman , Alain Junod , and Henri Bounameaux Single-Detector Helical Computed Tomography as the Primary Diagnostic Test in Suspected Pulmonary Embolism: A Multicenter Clinical Management Study of 510 Patients Marco J.L. van Strijen , Wouter de Mony , Jan Schiereck , Gerard J. Kieft , Martin H. Prins , Menno V. Huisman , Peter M.T. Pattynama , and Meta-Analysis: Outcomes in Patients with Suspected Pulmonary Embolism Managed with Computed Tomographic Pulmonary Angiography Lisa K. Moores , William L. Jackson Jr. , Andrew F. Shorr , and Jeffrey L. Jackson Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Pieter W. Kamphuisen and Giancarlo Agnelli Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Lisa K. Moores and William L. Jackson Jr Defining the Role of Computed Tomographic Pulmonary Angiography in Suspected Pulmonary Embolism Shaun D. Frost Metrics Cited byOutcomes following a negative computed tomography pulmonary angiography according to pulmonary embolism prevalence: a meta‐analysis of the management outcome studies 3 May 2005Volume 142, Issue 9Page: 801KeywordsAngiographyComputed axial tomographyConflicts of interestDeep vein thrombosisProspective studiesPulmonary embolismUltrasound imaging ePublished: 3 May 2005 Issue Published: 3 May 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...