ArticleResearch and practice in thrombosis and haemostasis2020
Establishing diagnostic criteria and treatment of subsegmental pulmonary embolism: A Delphi analysis of experts.
Article in Research and practice in thrombosis and haemostasis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 30 citations in OpenAlex.
- Review
- Increasing pulmonary artery visibility and diagnostic confidence with ultra-high resolution photon-counting detector CT pulmonary angiography.European radiology · 2026Article
- Detectability of subsegmental lesions in patients with inoperable CTEPH: Comparison between ultra-high-resolution vs. conventional CT.JHLT open · 2025Article
- Article
- Enhanced classification performance using deep learning based segmentation for pulmonary embolism detection in CT angiography.Heliyon · 2024Article
- Exploring varied radiologic appearance in pulmonary embolism with CT pulmonary angiography: Case series with literature review.Radiology case reports · 2024Article
- The History of Diagnosing Venous Thromboembolism.Seminars in thrombosis and hemostasis · 2024Review
- Prevalence of and Eligibility for Surveillance Without Anticoagulation Among Adults With Lower-Risk Acute Subsegmental Pulmonary Embolism.JAMA network open · 2023Article
- Epidemiology and prevention of venous thromboembolism.Nature reviews. Cardiology · 2023Review
- Management and Outcomes of Adults Diagnosed with Acute Pulmonary Embolism in Primary Care: Community-Based Retrospective Cohort Study.Journal of general internal medicine · 2022Article
- ERS International Congress 2021: highlights from the Pulmonary Vascular Diseases Assembly.ERJ open research · 2022Review
- Challenges in Managing Isolated Subsegmental Pulmonary Embolism.The Permanente journal · 2021Article
- Incidence of thrombotic complications and overall survival in hospitalized patients with COVID-19 in the second and first wave.Thrombosis research · 2021Article
- Establishing diagnostic criteria and treatment of subsegmental pulmonary embolism: A Delphi analysis of experts.Research and practice in thrombosis and haemostasis · 2020Article
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImproved imaging techniques have increased the incidence of subsegmental pulmonary embolism (ssPE). Indirect evidence is suggesting that ssPE may represent a more benign presentation of venous thromboembolism not necessarily requiring anticoagulant treatment. However, correctly diagnosing ssPE is challenging with reported low interobserver agreement, partly due to the lack of widely accepted diagnostic criteria.
objectivesWe sought to derive uniform diagnostic criteria for ssPE, guided by expert consensus.
methodsBased on an extensive literature review and expert opinion of a Delphi steering committee, two surveys including statements regarding diagnostic criteria and management options for ssPE were established. These surveys were conducted electronically among two panels, respectively: expert thoracic radiologists and clinical venous thromboembolism specialists. The Delphi method was used to achieve consensus after multiple survey rounds. Consensus was defined as a level of agreement >70%.
resultsTwenty-nine of 40 invited radiologists (73%) and 40 of 51 clinicians (78%) participated. Following two survey rounds by the expert radiologists, consensus was achieved on 15 of 16 statements, including on the established diagnostic criteria for ssPE (96% agreement): a contrast defect in a subsegmental artery, that is, the first arterial branch division of any segmental artery independent of artery diameter, visible in at least two subsequent axial slices, using a computed tomography scanner with a desired maximum collimator width of ≤1 mm. These criteria were approved by 83% of the clinical venous thromboembolism (VTE) specialists. The clinical expert panel favored anticoagulant treatment in case of prior VTE, antiphospholipid syndrome, pregnancy, cancer, and proximal deep vein thrombosis.
conclusionThe results of this analysis provide standard radiological criteria for ssPE that may be applicable in both clinical trials and practice.
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