Ventilation/perfusion lung scanning is the routine initial diagnostic test for patients presenting with clinical symptoms suggestive of pulmonary embolism (PE). In patients with a high clinical pretest probability of PE who nevertheless have had a low-probability lung scan, the incidence of PE on pulmonary angiography is 40% (95% confidence interval [CI], 16 to 68%). The next diagnostic test these patients usually undergo is a lower extremity venous ultrasound examination, and if this is negative, they proceed to pulmonary angiography fully natural asthma treatment. The purpose of this study was to determine the frequency of PE determined by pulmonary arteriography in patients who have had low-probability lung scans and negative lower extremity venous ultrasound examinations but who have a high clinical pretest suspicion for PE.

Materials and Methods

A retrospective review was undertaken of the medical records of all patients who had undergone pulmonary angiography for the diagnosis of PE between February 1993 and December 1996. The interpretation of lung scans was performed using the revised prospective investigation of PE diagnosis criteria.
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