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Clinical Investigations: PULMONARY EMBOLISM |

Frequency of Pulmonary Embolism in Patients with Low-Probability Lung Scan and Negative Lower Extremity Venous Ultrasound*

Michael F. Meyerovitz, MD; Finn Mannting, MD; Joseph F. Polak, MD; Samuel Z. Goldhaber, MD, FCCP
Author and Funding Information

*From the Departments of Radiology (Drs. Meyerovitz, Mannting, and Polak) and Medicine (Dr. Goldhaber), Brigham and Women’s Hospital and Harvard Medical School, Boston, MA.



Chest. 1999;115(4):980-982. doi:10.1378/chest.115.4.980
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Study objectives: To define the prevalence of pulmonary embolism (PE) in patients who are undergoing pulmonary arteriography because of a high clinical suspicion for PE but who have had a low-probability lung scan and a negative lower extremity venous ultrasound examination.

Design: A retrospective review of the medical records of 365 consecutive patients who underwent pulmonary arteriograms for suspected PE was undertaken.

Results: Of the 365 pulmonary arteriograms, 62 were performed in patients with suspected PEs despite a low-probability lung scan and a negative lower extremity venous ultrasound examination. In the latter group, five patients (8%; 95% confidence interval, 2.7% to 18%) had PEs revealed on the arteriogram.

Conclusions: In patients whose presentation provokes a high clinical suspicion for PE despite having had a low-probability lung scan, a negative lower extremity venous ultrasound examination is insufficient to preclude proceeding to pulmonary angiography.

Abbreviations: CI = confidence interval; PE = pulmonary embolism


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