Abstract:

An important clinical challenge the management of patients with pulmonary embolism is to determine prognosis of the treatment generally, and thrombolytic reperfusion therapy as the main component of a specific pathogenetic treatment in particular. This knowledge is necessary to adjust the plan of remedial measures, the intensification of concomitant pharmacotherapy and provide a personalized approach to patients with thromboembolic lesions of the pulmonary circulation

Aim: was to identify reliable predictors of the onset of reperfusion in patients with pulmonary thromboembolism based on methods of radiographic diagnosis.

Materials and Methods: 138 patients (73 women and 65 men) underwent examination. Age of patients ranged from 20 to 80 years (mean age 55±25 years). The first group includes observation of 102 patients admitted to hospital in early stages of disease ( 1 month after onset of symptoms). The second group consisted of 36 patients admitted to the hospital at a later date (from 1.5 to 12 months). In groups we studied predictors of pulmonary reperfusion channel on the basis of direct angiography and multislice computed tomography As a control, a diagnostic method used direct angiography, which has a high sensitivity and specificity in identifying symptoms of pulmonary embolism. Using the method of multiple logistic regression odds ratios were prepared to achieve reperfusion in patients with certain diagnostic symptoms compared with patients who have no signs data in angiography

Results: diagnostic criteria, in presence of which on angio-pulmonography significantly increased the likelihood of reperfusion are «amputation» of segmental branches of the pulmonary artery ( p<0.05, 16,55(6,50-42,09 ) ), intraluminal defects of contrast staining (p < 0.05, 30.56 (8,66-107,84)) and the absence of distal blood flow (p<0,05; 6,16(2,47-15,40)). Signs, significantly reducing chances of achieving reperfusion are tortuosity of segmental branches of the pulmonary artery (p<0,05; 0,03(0,01-0,08)), slowing of contrast branches of the pulmonary artery (p<0,05; 0,11( 0.05-0.25)), and the presence of defects in the near-wall staining (p<0,05; 73,182 (9,606-557,542)).

Conclusions: basing on results of modern beam-diagnostics may reliably predict the likelihood of reperfusion in patients with pulmonary embolism.

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