Should We Look for Silent PE in Patients with DVT?

Although one third of patients with lower-extremity deep venous thrombosis exhibited silent pulmonary embolism, routine screening for PE generally does not change management.

Autopsy studies have shown that, even in patients with large or fatal pulmonary embolisms (PEs), most cases were unsuspected or undiagnosed ante mortem. This finding begs the question: Should standard screening for PE be performed in patients with deep venous thrombosis (DVT) but without clinical symptoms of PE? Researchers conducted a systematic review of 28 prospective studies to estimate the prevalence of silent PE in patients with DVT. The investigations were stratified into two tiers. Tier 1 included studies in which PE was diagnosed by “high-probability” ventilation/perfusion (V/Q) scans (PIOPED criteria; JW Gen Med May 29 1990) or by pulmonary angiography (computed tomography or conventional angiography). Tier 2 included studies in w…

Reviewing Author

Aaron J. Calderon, MD, FACP

Disclosures

EquityAbbott; Medtronic; Merck; Pfizer; CVS Health Corp.; Bristol Myers Squibb

Aaron J. Calderon, MD, FACP

Disclosures

EquityAbbott; Medtronic; Merck; Pfizer; CVS Health Corp.; Bristol Myers Squibb