Vasculature obstruction level in pulmonary embolism and risk of pulmonary infarction

Abstract

The purpose of this work was to study the effect of the obstruction level associated with pulmonary embolism (PE) on development of pulmonary infarction (PI) and infarction-related pneumonia. Materials and Methods. Patients ( n = 105) with PTE identified by results of multislice computed tomography (MSCT) with enhancement of pulmonary vessels were enrolled in the study. Among them patients with high risk PTE, survived the 1st week of the disease ( n = 53), and with community-acquired pneumonia ( n = 54) were present, and in these patients MSCT allowed to detect PTE was performed during week 1. Results. PI was detected in 58 (95.1%) of 61 PTE patients with obstruction of segmental pulmonary artery (PA) branches and 15 (32.6%) of 46 patients without obstruction of segmental arteries ( p < 0.001). In PTE patients with upper obstruction level in PA trunk region, the involvement of segmental branches and PI development were observed in 20.0% of cases, with upper obstruction level in main branches region it was reported, respectively, in 31.8 and 52.3% of patients, and with pulmonary branches involvement – in 80.0 and 100.0% of patients. Conclusion. PI development is associated with obstruction of segmental branches of PA. The incidence of segmental branches involvement and risk of PI are increased in association with decreased upper obstruction level of PA.