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The American College of Chest Physicians' 2021 venous thromboembolism (VTE) treatment guidelines recommend surveillance over anticoagulation for low-risk patients with isolated subsegmental pulmonary embolism (PE), after proximal deep venous thrombosis (DVT) has been ruled out (NEJM JW Gen Med Nov 1 2021 and Chest 2021; 160:e545). International investigators prospectively assessed 90-day outcomes in 292 patients (mean age, 56) with isolated subsegmental PE (single or multiple) who were managed without anticoagulation. Patients with active cancer, pregnancy, hospitalization at the time of PE diagnosis, or requirement for oxygen therapy were excluded.
Eighteen patients had proximal DVT at the time of subsegmental PE and required anticoagulatio…