Clinical analysis of patients with saddle pulmonary embolism and its comparison with the main pulmonary artery embolization

Abstract

Objective To evaluate the clinical characteristics of patients with saddle pulmonary embolism (SPE) and its comparison with left and right main pulmonary artery embolization. Methods The clinical data of 17 patients with saddle pulmonary thromboembolism from August 2011 to February 2015 were retrospectively analyzed. And 96 patients with pulmonary embolism in right and/or left pulmonary artery were enrolled as the non-SPE group. The hypertension, surgery or trauma within 3 months, pulse, systolic blood pressure, diastolic blood pressure, shock or hypotension, D-dimer, serum cardiac troponin Ⅰ, partial pressure of blood oxygen, oxygenation index, N-terminal pro-brain nitric peptide, right ventricular dysfunction and right ventricular systolic blood pressure were compared between the two groups. Meanwhile, the death cases in 3 months were recorded during the follow-up. Results The main clinical symptom in the SPE group and non-SPE group were dyspnea (12/17 vs. 74/96), cough (6/17 vs. 20/96), chest pain (5/17 vs. 15/96) and syncope (5/17 vs. 17/96), and there were no siginificant differences among the above symptoms (χ2 = 0.335, 1.705, 1.885, 1.262; P = 0.563, 0.192, 0.170, 0.261). And in the SPE group, the surgery or trauma within 3 months (6/17 vs. 9/96, χ2 = 8.428, P = 0.004) and partial pressure of blood oxygen [(89 ± 25) mmHg vs. (79 ± 25) mmHg, t = 2.002, P = 0.045] were much higher than those in the non-SPE group. All patients were hospitalized and no patient died during the hospitalization. Two cases in the non-SPE group died of pulmonary embolism, but no case died in the SPE group within 3 months. Conclusion The short-term prognosis of patients with saddle pulmonary thromboembolism is not inferior to that of patients with pulmonary trunk embolism, and the patients can be treated according to the risk stratification of pulmonary embolism rather than whether having saddle or not. Key words: Pulmonary embolism; Thromboembolism; Saddle pulmonary embolism; Death