CTA improves, complicates management of PE

Researchers in Canada and the U.S. have found CT angiography to be as safe and accurate as ventilation/perfusion lung scans for ruling out pulmonary emboli. Results from what may be the first study of its kind suggest, however, that CTA could also spot many clinically irrelevant thrombi.

Dr. David R. Anderson and colleagues at one U.S. and four Canadian tertiary-care centers enrolled 1417 consecutive patients with suspected PE between May 2001 and April 2005. Patients were randomized to undergo either V/Q scanning (n = 716) or CTA (n = 701). Almost 20% of patients randomized to CTA were diagnosed with PE or deep vein thrombosis during the initial evaluation period, while 14.2% of patients in the V/Q scanning group had a similar diagnosis. Researchers cautioned that CTA could lead in many cases to unwarranted anticoagulant therapy. They published their findings in the Dec. 19 issue of the Journal of the American Medical Association.