Prognostic factors of clot resolution on follow-up computed tomography angiography and recurrence after a first acute pulmonary embolism.

Background: Recent studies seem to confirm the relationship between residual pulmonary obstruction (RPO) in pulmonary embolism (PE) and risk of recurrent thrombosis and chronic thromboembolic pulmonary hypertension (CTEPH). However, the prognostic factors associated with PE resolution on follow-up computed tomography angiography (CTA) are not clear.

Objectives: To determine the prognostic factors of resolution of PE diagnosed and monitored by CTA and the impact of RPO on late complications.

A significant decrease in D-dimer concentration within one month of anticoagulation therapy as a predictor of both complete recanalization and risk of recurrence after initial pulmonary embolism.

Background: Abnormal D-dimer concentration measured during anticoagulation therapy (AT) or within one month of discontinuation, is associated with residual pulmonary obstruction (RPO) and risk of recurrent venous thromboembolism (VTE) after a first episode of pulmonary embolism (PE). We hypothesized that a significant decrease in D-dimer concentration within the first month of AT in patients with a first episode of PE may predict complete recanalization and a lower risk of recurrent VTE.

Methods: One hundred and fifty patients with PE received anticoagulation therapy for three or six months when control computed tomography angiography (CTA) was performed.