Titre :

Establishing diagnostic criteria and treatment of subsegmental pulmonary embolism: A Delphi analysis of experts.

Auteur(s) :

Den Exter, Paul L. [Auteur]
Leiden University Medical Center [LUMC]
Kroft, Lucia J. M. [Auteur]
Leiden University Medical Center [LUMC]
Gonsalves, Carole [Auteur]
University of Ottawa [Ottawa]
Le Gal, Grégoire [Auteur]
University of Ottawa [Ottawa]
Schaefer-Prokop, Cornelia M. [Auteur]
Radboud University Medical Center [Nijmegen]
Carrier, Marc [Auteur]
University of Ottawa [Ottawa]
Huisman, Menno V. [Auteur]
Leiden University Medical Center [LUMC]
Klok, Frederikus A. [Auteur]
Leiden University Medical Center [LUMC]
Meijboom, L. [Auteur]
VU University Medical Center [Amsterdam]
Beenen, L. F. [Auteur]

De Roos, A. [Auteur]
Leiden University Medical Center [LUMC]
Hartmann, I. [Auteur]
Maasstad Ziekenhuis = Maasstad Hospital
Dennie, C. [Auteur]
University of Ottawa [Ottawa]
Revel, M. P. [Auteur]
Hôpital Cochin [AP-HP]
Haramati, L. [Auteur]
Van Beek, E. [Auteur]
Screaton, N. [Auteur]
Ferretti, G. [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Ghaye, B. [Auteur]
Cliniques Universitaires Saint-Luc [Bruxelles]
Das, M. [Auteur]
White, C. [Auteur]
University of Maryland [Baltimore]
Pena Fernandez, E. [Auteur]
University of Ottawa [Ottawa]
Paul, N. [Auteur]
University of Toronto
Vlahos, I. [Auteur]
St George’s University Hospitals
Renapurkar, R. D. [Auteur]
Cleveland Clinic
Ravenel, J. [Auteur]
Medical University of South Carolina [Charleston] [MUSC]
Kanne, J. [Auteur]
University of Wisconsin School of Medicine and Public Health
Abbara, S. [Auteur]
Remy, Martine [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Geurts, B. [Auteur]
Radboud University Medical Center [Nijmegen]
Frauenfelder, T. [Auteur]
Universität Zürich [Zürich] = University of Zurich [UZH]
Sverzellati, N. [Auteur]
Università degli studi di Parma = University of Parma [UNIPR]
Prosch, H. [Auteur]
Medizinische Universität Wien = Medical University of Vienna
Goo, J. M. [Auteur]
Seoul National University [Seoul] [SNU]
Vogel-Claussen, J. [Auteur]
Medizinische Hochschule Hannover = Hannover Medical School [MHH]
Macmahon, P. J. [Auteur]
University College Dublin [Dublin] [UCD]
Bhalla, S. [Auteur]
Washington University School of Medicine [Saint Louis, MO]
Kahn, S. [Auteur]
McGill University = Université McGill [Montréal, Canada]
Shivakumar, S. [Auteur]
Dalhousie University [Halifax]
Wells, P. [Auteur]
University of Ottawa [Ottawa]
Rodger, M. [Auteur]
University of Ottawa [Ottawa]
Castellucci, L. [Auteur]
University of Ottawa [Ottawa]
Duffett, L. [Auteur]
University of Ottawa [Ottawa]
Delluc, A. [Auteur]
University of Ottawa [Ottawa]
Siegal, D. [Auteur]
McMaster University [Hamilton, Ontario]
Lazo-Langner, A. [Auteur]
University of Western Ontario [UWO]
Wu, C. [Auteur]
University of Alberta
Lee, A. [Auteur]
St. Paul’s Hospital - University of British Columbia [Vancouver, BC, Canada] [SPH-UBC]
Garcia, D. [Auteur]
Washington University School of Medicine [Saint Louis, MO]
Zwicker, J. [Auteur]
Harvard University
Aujesky, D. [Auteur]
Université de Lausanne = University of Lausanne [UNIL]
Jimenez, D. [Auteur]
Righini, M. [Auteur]
Hôpitaux Universitaires de Genève [HUG]
Blondon, M. [Auteur]
Hôpitaux universitaires de Genève = University Hospitals of Geneva [HUG]
Ay, C. [Auteur]
Medizinische Universität Wien = Medical University of Vienna
Barco, S. [Auteur]
University Medical Center [Mainz]
Kamphuisen, P. W. [Auteur]
Ferreira, M. [Auteur]
Hospital Garcia de Orta [EPE]
Sanchez, O. [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Moores, L. K. [Auteur]
Tromeur, C. [Auteur]
Hôpital de la Cavale Blanche - CHRU Brest [CHU - BREST ]
Ageno, W. [Auteur]
Universitá degli Studi dell’Insubria = University of Insubria [Varese] [Uninsubria]
Hunt, B. [Auteur]
Guy's and St Thomas' NHS Foundation Trust
Prandoni, P. [Auteur]
Università degli Studi di Padova = University of Padua [Unipd]
Monreal, M. [Auteur]
Roy, P. M. [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Pabinger, I. [Auteur]
Medizinische Universität Wien = Medical University of Vienna
Donadini, M. P. [Auteur]
Moustafa, F. [Auteur]
Université Clermont Auvergne [2017-2020] [UCA [2017-2020]]
Jara-Palomares, L. [Auteur]
Hospital Universitario Virgen del Rocío [Sevilla]
Pedroc, R. [Auteur]
Bertoletti, L. [Auteur]
Verhamme, P. [Auteur]
Universitair Ziekenhuis Leuven [UZ Leuven]
Eikenboom, H. [Auteur]
Leiden University Medical Center [LUMC]
Van Der Meer, F. [Auteur]
Leiden University Medical Center [LUMC]
Büller, H. R. [Auteur]

Van Es, N. [Auteur]

Titre de la revue :

Research and Practice in Thrombosis and Haemostasis

Nom court de la revue :

Res Pract Thromb Haemost

Numéro :

4

Pagination :

1251-1261

Date de publication :

2020-12-16

ISSN :

2475-0379

Mot(s)-clé(s) en anglais :

anticoagulant treatment
Delphi analysis
diagnosis
pulmonary embolism
subsegmental

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Background Improved imaging techniques have increased the incidence of subsegmental pulmonary embolism (ssPE). Indirect evidence is suggesting that ssPE may represent a more benign presentation of venous thromboembolism ...
Lire la suite >Background Improved imaging techniques have increased the incidence of subsegmental pulmonary embolism (ssPE). Indirect evidence is suggesting that ssPE may represent a more benign presentation of venous thromboembolism not necessarily requiring anticoagulant treatment. However, correctly diagnosing ssPE is challenging with reported low interobserver agreement, partly due to the lack of widely accepted diagnostic criteria. Objectives We sought to derive uniform diagnostic criteria for ssPE, guided by expert consensus. Methods Based on an extensive literature review and expert opinion of a Delphi steering committee, two surveys including statements regarding diagnostic criteria and management options for ssPE were established. These surveys were conducted electronically among two panels, respectively: expert thoracic radiologists and clinical venous thromboembolism specialists. The Delphi method was used to achieve consensus after multiple survey rounds. Consensus was defined as a level of agreement >70%. Results Twenty‐nine of 40 invited radiologists (73%) and 40 of 51 clinicians (78%) participated. Following two survey rounds by the expert radiologists, consensus was achieved on 15 of 16 statements, including on the established diagnostic criteria for ssPE (96% agreement): a contrast defect in a subsegmental artery, that is, the first arterial branch division of any segmental artery independent of artery diameter, visible in at least two subsequent axial slices, using a computed tomography scanner with a desired maximum collimator width of ≤1 mm. These criteria were approved by 83% of the clinical venous thromboembolism (VTE) specialists. The clinical expert panel favored anticoagulant treatment in case of prior VTE, antiphospholipid syndrome, pregnancy, cancer, and proximal deep vein thrombosis. Conclusion The results of this analysis provide standard radiological criteria for ssPE that may be applicable in both clinical trials and practice.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2023-11-15T07:36:56Z
2024-01-11T14:21:38Z