Management of single subsegmental pulmonary embolism: a prospective observational study at North Shore and Waitakere Hospitals, Auckland.

Background: Single subsegmental pulmonary embolism is increasingly diagnosed but the benefit to anticoagulate in the absence of concurrent deep vein thrombosis is not consistently established.

Aims: To investigate the safety of an observational approach in patients with isolated subsegmental pulmonary embolism and the utility of the second lower limb ultrasound after 7 days.

Methods: Prospective observational study of patients diagnosed with isolated subsegmental pulmonary embolism between July 2016 and July 2020 at North Shore and Waitakere Hospitals, Auckland.

Management and outcomes of axial isolated distal deep vein thrombosis at North Shore Hospital, New Zealand: a retrospective audit.

Background: It is standard of care to treat proximal vein deep vein thrombosis (DVT) for a minimum of 3 months. Conversely, management of isolated distal DVT (IDDVT) is controversial, with options including observation and repeat ultrasound scan within 1 week to detect and anticoagulate those with proximal propagation, or anticoagulation for periods of up to 3 months.

Aim: The aim was to assess the rates of proximal propagation and venous thromboembolism (VTE) recurrence within 3 months of diagnosis of IDDVT, and to examine how the duration of treatment might influence this.

Management and outcomes of single subsegmental pulmonary embolus: a retrospective audit at North Shore Hospital, New Zealand.

Background: It is unknown whether filling defects in subsegmental arteries on multidetector computed tomography pulmonary angiography correlate with clinically relevant subsegmental pulmonary embolism (PE) on pulmonary angiography. Current guidelines do not differentiate between PE in segmental and subsegmental vessels, and many patients receive at least 3 months anticoagulation. The strategy employed at North Shore Hospital in haemodynamically stable patients with single subsegmental PE is to perform bilateral lower leg compression ultrasound (CUS).

Post-treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality.

Background: Recurrent thromboembolic events after an initial deep vein thrombosis (DVT) are relatively frequent. Residual thrombus in the affected veins on ultrasound scan at the completion of anticoagulant therapy has been described as a recurrence risk factor, and may have utility in stratifying those patients at risk.

Objectives: The aims of the study were to correlate the risk of recurrence of DVT with the results of ultrasound at completion of oral anticoagulant therapy.