Elsevier

Progress in Cardiovascular Diseases

Volume 37, Issue 2, September–October 1994, Pages 93-105
Progress in Cardiovascular Diseases

Pulmonary angiography and the diagnosis of pulmonary embolism

https://doi.org/10.1016/S0033-0620(05)80045-3Get rights and content

Summary

Pulmonary angiography is the definitive study for the identification of embolism. The development of accurate noninvasive methods for the detection of deep venous thrombosis has altered the indications for angiography. Many angiographic techniques have been developed, providing the opportunity to tailor the angiogram to the clinical situation of individual patients. Strict criteria must be used for interpretation of angiographic studies, and using state of the art equipment will diminish technically unsatisfactory examinations. CT and MR angiography will assume a significantly larger role in the identification of PE in the very near future. MR may become the method of choice, because it is the one noninvasive technique that shows promise for the study of both the deep venous system of the legs and pelvis and the pulmonary circulation.

References (71)

  • PriceL et al.

    Are modifications necessary in the performance of pulmonary angiograms?

    Chest

    (1985)
  • SteinPD

    Wedge arteriography for the identification of pulmonary emboli in small vessels

    Am Heart J

    (1971)
  • PondGD

    Pulmonary digital subtraction angiography

    Radiol Clin North Am

    (1985)
  • OudkerkM et al.

    Digital subtraction angiography in abnormal perfusion scintigraphy of the lungs

    Eur J Radiol

    (1990)
  • DalenJE

    Diagnosis of acute pulmonary embolism

  • The Urokinase Pulmonary Embolism Trial

    Circulation

    (1973)
  • DalenJE et al.

    Pulmonary embolism

    JAMA

    (1969)
  • SzucsMM et al.

    Diagnostic sensitivity laboratory findings in acute pulmonary embolism

    Ann Intern Med

    (1971)
  • CaranasosGJ et al.

    Drug induced illness leading to hospitalization

    JAMA

    (1974)
  • WestermarkN

    On the roentgen diagnosis of lung embolism

    Acta Radiol

    (1938)
  • ShapiroR et al.

    Pulmonary embolism without infarction

    Am J Roentgen

    (1948)
  • GreenspanRH et al.

    Accuracy of the chest radiograph in the diagnosis of pulmonary embolism

    Invest Radiol

    (1982)
  • GreenspanRH

    Does a normal isotope perfusion scan exclude pulmonary embolism

    Invest Radiol

    (1973)
  • NewmanGE

    Pulmonary angiography in pulmonary embolic disease

    J Thorac Imag

    (1989)
  • The PIOPED Investigators

    Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED)

    JAMA

    (1991)
  • QuinnRJ et al.

    A decision analysis approach to the treatment of patients with suspected pulmonary embolism and an intermediate probability lung scan

    J Nucl Med

    (1991)
  • HullRD et al.

    Clinical validity of a negativ venogram in patients with clinically suspected venous thrombosis

    Circulation

    (1981)
  • HullRD et al.

    Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion scan

    Ann Intern Med

    (1983)
  • FerrisEJ et al.

    Holmes Lecture. Deep venous thrombosis and pulmonary embolism: correlative evaluation and therapeutic implications

    AJR

    (1992)
  • DalenJE et al.

    Resolution rate of acute pulmonary embolism in man

    N Engl J Med

    (1969)
  • SteinPD et al.

    Complications and validity of pulmonary angiography in acute pulmonary embolism

    Circulation

    (1992)
  • GreenspanRH et al.

    In vivo magnification angiography

    Invest Radiol

    (1976)
  • MillsSR et al.

    The incidence, etiologies, and avoidance of complications of pulmonary angiography in a large series

    Radiology

    (1980)
  • BettmanMA et al.

    Comparison of an ionic with a non-ionic contrast agent for cardiac angiography. Results of a multicenter trial

    Invest Radiol

    (1985)
  • HirshfieldJW et al.

    Hemodynamic and electrocardiographic effects of ioversol during cardiac angiography: Comparison with iopamidol and diatrizoate

    Invest Radiol

    (1989)
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