Diagnosis, management and prognosis of symptomatic and incidental pulmonary embolism

Abstract

This thesis describes studies that aimed to evaluate and improve the diagnostic work-up and management of pulmonary embolism. Age-adjusted D-dimer testing was found to be an effective and safe strategy to reduce the need for CT-imaging in elderly patients with clinically suspected pulmonary embolism. Furthermore, this thesis demonstrates that patients with proven pulmonary embolism who fulfil the Hestia criteria can be safely treated at home, without the need for further prognostic assessment. In the vast majority of patients treated for pulmonary embolism, complete thromboembolic resolution had occurred after six months as assessed by CT pulmonary angiography. The last part of this thesis describes that the outcome of cancer patients incidentally diagnosed with pulmonary embolism mimics the outcome of cancer patients with symptomatic pulmonary embolism.