Aramberri Mario, Benegas Mariana, Sanchez Marcelo, Muñoz-Guglielmetti Diego, Zamora Carles, García-Villa Adrián, Diaz-Pedroche Carmen, Font Carme
Department of Internal Medicine, Hospital de Galdakao-Usansolo, Galdakao, Spain.
Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain.
TH Open. 2022 Sep 26;6(3):e267-e275. doi: 10.1055/a-1892-1987. eCollection 2022 Jul.
There is scarce information regarding the prevalence and clinical impact of saddle pulmonary embolism (PE) in patients with cancer. This study aimed to assess the prevalence, clinical findings, and short-term outcomes of patients with cancer-related saddle PE including acute symptomatic and unsuspected events. Consecutive patients with cancer-related PE (March 1, 2006-October 31, 2014) were retrospectively reviewed by a chest radiologist to assess PE burden and signs of right ventricular (RV) overload. The clinical outcomes within 30 days were evaluated according to saddle versus nonsaddle PE. Thirty-six (12%) out of 289 patients with newly diagnosed cancer-related PE presented with saddle PE. Saddle PE was found in 21 cases (58%) with acute symptomatic PE and the remaining 15 cases (42%) were found as unsuspected findings. Patients with saddle PE had more frequently experienced a previous thrombotic event (31 vs. 13%; = 0.008), and it occurred more frequently as an acute symptomatic event (58 vs. 39%; = 0.025) compared with those with nonsaddle PE. Signs of RV overload including RV/left ventricle ratio ≥1 (22 vs. 4%; < 0.001) and interventricular septum displacement (53 vs. 20%; < 0.001) were also more common in patients with saddle PE compared with nonsaddle PE. Overall, PE-related mortality, venous thromboembolism recurrence, and major bleeding within 30 days were found to be similar according to saddle versus nonsaddle PE. Saddle PE is not uncommon in patients with cancer-related PE including in those with unsuspected PE. Similar 30-day outcomes were found according to saddle versus nonsaddle PE in our cohort.
关于癌症患者中马鞍型肺栓塞（PE）的患病率及临床影响的信息匮乏。本研究旨在评估癌症相关马鞍型PE患者的患病率、临床特征及短期预后，包括急性有症状和无症状事件。由一名胸部放射科医生对2006年3月1日至2014年10月31日期间连续的癌症相关PE患者进行回顾性分析，以评估PE负荷及右心室（RV）超负荷的体征。根据是否为马鞍型PE评估30天内的临床结局。289例新诊断的癌症相关PE患者中，36例（12%）为马鞍型PE。在21例（58%）急性有症状PE患者中发现马鞍型PE，其余15例（42%）为意外发现。与非马鞍型PE患者相比，马鞍型PE患者既往血栓形成事件更常见（31%对13%；P = 0.008），且急性有症状事件更常见（58%对39%；P = 0.025）。与非马鞍型PE患者相比，马鞍型PE患者右心室超负荷体征也更常见，包括右心室/左心室比率≥1（22%对4%；P < 0.001）和室间隔移位（53%对20%；P < 0.001）。总体而言，根据是否为马鞍型PE，30天内PE相关死亡率、静脉血栓栓塞复发率及大出血发生率相似。马鞍型PE在癌症相关PE患者中并不少见，包括无症状PE患者。在我们的队列中，马鞍型PE与非马鞍型PE的30天结局相似。
