Chronic pulmonary embolism in Klippel-Trenaunay syndrome - 16/12/11
Abstract |
Background |
Klippel-Trenaunay syndrome (KTS) is characterized by vascular malformations and disturbed soft tissue or bony growth, involving one or more extremities. A high incidence of venous thromboembolism (VTE) has been reported in this disorder, along with cases of belated diagnosed chronic thromboembolic (CTE) pulmonary hypertension (CTEPH). We performed a cross-sectional study to investigate the prevalence of CTE in patients with KTS.
Methods |
Those from our KTS patient cohort willing to participate were examined with a sequential diagnostic workup including perfusion scintigraphy, computed tomography, and echocardiography.
Results |
Of 68 patients, 48 patients participated in the study (median age 43 years; 29 [60%] were female). Eleven patients (23%) had an abnormal perfusion scan result, of whom computed tomographic scanning showed signs of CTE in two patients (4.2%; 95% confidence interval [CI] 1.2%-14%); both patients had a history of VTE. Echocardiography showed no signs of CTEPH in these patients. In total, 23 patients (48%; 95% CI 35%-62%) had a history of superficial vein thrombosis and 8 patients (17%; 95% CI 8.7%-30%) had a history of deep vein thrombosis or pulmonary embolism, which was associated with more shortness of breath.
Limitations |
Echocardiography was only performed in patients with CTE.
Conclusion |
A large proportion of patients with KTS had a history of VTE. The prevalence of CTE in the total KTS cohort, however, appeared less alarming than previously assumed. Based on these results, we suggest that there is only a limited indication for CTEPH screening among patients with KTS. Nevertheless, awareness for CTEPH remains appropriate, especially among patients presenting with shortness of breath and a history of VTE.
Le texte complet de cet article est disponible en PDF.Key words : chronic thromboembolic pulmonary hypertension, chronic thromboembolism, Klippel-Trenaunay syndrome, pulmonary embolism, vascular malformations, venous thromboembolism
Abbreviations used : CI, CT, CTE, CTEPH, DVT, KTS, PE, SVT, VTE
Plan
Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 66 - N° 1
P. 71-77 - janvier 2012 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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