Oui, selon cet article la fr�quence serait de 40 � 50%...
Systematic Lung Scans Reveal a High Frequency of Silent Pulmonary Embolism in Patients With Proximal Deep Venous Thrombosis Michel Meignan, MD; Jean Rosso, MD; H�l�ne Gauthier, MD; Fran�oise Brunengo, MD; Sophie Claudel, PhD; Luc Sagnard, MD; Pascal d'Azemar, MD; G�rald Simonneau, MD; Bernard Charbonnier, MD Background A high frequency of asymptomatic pulmonary embolism (PE) has been reported in patients with deep venous thrombosis (DVT) in studies of a limited number of patients using varying criteria for lung scan assessment. Objectives To estimate the frequency of PE using systematic lung scans in a large group of outpatients with DVT and to compare the results using varying lung scan assessment criteria. Methods An international multicenter study comparing 2 different regimens of low-molecular-weight heparin nadroparin in DVT: perfusion lung scans were performed in 622 outpatients with no clinical indication of PE and with proximal DVT confirmed by venography. Three hundred seventy-nine of these patients underwent ventilation lung scans. High-probability (HP) scans for PE were assessed separately using either ventilation scans or chest radiographs to define mismatched perfusion defects. Results Perfusion scans showed abnormalities in 82% of the patients; 59% had segmental defects and 30% had normal scans or scans with a very low probability of PE. Depending on the criteria used, 32% to 45% had HP scans for PE; these percentages were higher in young patients. No relationship was found between extent of thrombosis and HP scans. The estimated frequency of silent PE was 39.5% to 49.5%. During a 3-month follow-up period during which the patients received therapy, the rate of PE recurrence was low (1.3%) and did not differ between patients with baseline HP scans and those with normal scans. Conclusions Regardless of what interpretative criteria are used for assessing lung scans in PE, the frequency of silent PE is 40% to 50% in patients with DVT. A baseline lung scan may easily detect PE in these patients but is not useful for predicting early thromboembolic recurrences that may occur during therapy. Arch Intern Med. 2000;160:159-164 Jean Levasseur CHRDL, Joliette -----Message d'origine----- De�: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] De la part de Martin Chenier Envoy�: 12 mars, 2003 09:09 ��: URG-L Mailing List Objet�: URG-L: [Pas de sujet] Faut dire �galement qu'on trouverait chez la plupart des patients avec une TPP proximale des embolies pulmonaires si l'investigation �tait pouss�e � fond. Je te r�f�re au texte du consensus � ce sujet. MC Tu as �crit: > Tu as �crit: > > Une "derni�re" toute petite question sur les TPP.Traitez-vous en externe > > imm�diatement(i.e. d�s que le Dx est pos� avec certitude)toutes les TPP > > du MI � savoir aussi proximales soient-elles? Et si le doppler parle de > > "thrombus flottant",en externe aussi? Je sais que le Tx est le m�me,je > > sais aussi que thrombus flottant ou pas,embolie pulmonaire ou pas,le Tx > > est le m�me...mais j'ai une esp�ce de blocage � donner cong� � ces > > patients imm�diatement apr�s le Dx et le d�but de l'HBPM. > > > > C. > > -Il existe des crit�res pour traiter en externe. Tu trouveras un r�sum� des > crit�res � l'adresse suivante : > > http://www.chestnet.org/guidelines/antithrombotic/p9.php > > - > Martin Ch�nier > > --- URG-L > Pour modifier votre adresse de courriel sur URG-L, envoyez un avis a > [EMAIL PROTECTED] en indiquant votre nouvelle adresse ainsi > que l'ancienne et le nom de la liste. -- Martin Ch�nier --- URG-L Pour modifier votre adresse de courriel sur URG-L, envoyez un avis a [EMAIL PROTECTED] en indiquant votre nouvelle adresse ainsi que l'ancienne et le nom de la liste. --- URG-L Aimeriez-vous obtenir une adresse de courriel @URGENCES.CA? Suivez-le lien http://www.groupegiroux.com/messagerie pour de plus amples informations.
