Clinical controversies in the management of acute pulmonary embolism: evaluation of four important but controversial aspects of acute pulmonary embolism management that are still subject of debate and research

References

• Huisman MV, Barco S, Cannegieter SC, et al. Pulmonary embolism. Nat Rev Dis Primers. 2018 May 17;4(1):18028.
   PubMedGoogle Scholar
• Barco S, Mahmoudpour SH, Valerio L, et al. Trends in mortality related to pulmonary embolism in the European Region, 2000–15: analysis of vital registration data from the WHO Mortality Database. Lancet Respir Med. 2020 Mar;8(3):277–287.
   PubMed Web of Science ®Google Scholar
• Dronkers CE, Klok FA, Huisman MV. Current and future perspectives in imaging of venous thromboembolism. J Thromb Haemost. 2016 Sep;14(9):1696–1710.
   PubMedGoogle Scholar
• Konstantinides SV, Meyer G, Becattini C, et al. ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Task Force for the diag manage of acute pulm embol of the Eur Heart J (ESC). 2019;1901647
   Google Scholar
• Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014;370(15):1402–1411.
   PubMed Web of Science ®Google Scholar
• Ortel TL, Neumann I, Ageno W, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv. 2020 Oct 13;4(19):4693–4738.
   PubMed Web of Science ®Google Scholar
• Barco S, Vicaut E, Klok FA, et al. Improved identification of thrombolysis candidates amongst intermediate-risk pulmonary embolism patients: implications for future trials. Eur Respir J. 2018;51(1):1701775.
   PubMedGoogle Scholar
• Hariharan P, Dudzinski DM, Rosovsky R, et al. Relation among clot burden, right-sided heart strain, and adverse events after acute pulmonary embolism. Am J Cardiol. 2016 Nov 15;118(10):1568–1573.
   PubMed Web of Science ®Google Scholar
• Levine M, Hirsh J, Weitz J, et al. A randomized trial of a single bolus dosage regimen of recombinant tissue plasminogen activator in patients with acute pulmonary embolism. Chest. 1990 Dec;98(6):1473–1479.
   PubMedGoogle Scholar
• Sharifi M, Bay C, Skrocki L, et al. Moderate pulmonary embolism treated with thrombolysis (from the “MOPETT” Trial). Am J Cardiol. 2013 Jan 15;111(2):273–277.
   PubMed Web of Science ®Google Scholar
• Goldhaber SZ, Agnelli G, Levine MN. Reduced dose bolus alteplase vs conventional alteplase infusion for pulmonary embolism thrombolysis: an international multicenter randomized trial. Chest. 1994 Sep 01;106(3):718–724.
   PubMedGoogle Scholar
• Sors H, Pacouret G, Azarian R, et al. Hemodynamic effects of bolus vs 2-h infusion of alteplase in acute massive pulmonary embolism. A randomized controlled multicenter trial. Chest. 1994 Sep;106(3):712–717.
   PubMedGoogle Scholar
• Wang C, Zhai Z, Yang Y, et al. Efficacy and safety of low dose recombinant tissue-type plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest. 2010 Feb;137(2):254–262.
   PubMed Web of Science ®Google Scholar
• Jimenez D, Martin-Saborido C, Muriel A, et al. Efficacy and safety outcomes of recanalisation procedures in patients with acute symptomatic pulmonary embolism: systematic review and network meta-analysis. Thorax. 2018 May;73(5):464–471.
   PubMedGoogle Scholar
• Sanchez O, Charles-Nelson A, Ageno W, et al. Reduced-dose intravenous thrombolysis for acute intermediate-high-risk pulmonary embolism: rationale and design of the pulmonary embolism international Thrombolysis (PEITHO)-3 trial. Thromb Haemost. 2022 May;122(5):857–866.
   PubMedGoogle Scholar
• Pruszczyk P, Klok FA, Kucher N, et al. Percutaneous treatment options for acute pulmonary embolism: a clinical consensus statement by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function and the European Association of Percutaneous Cardiovascular Interventions. EuroIntervention. 2022 Oct 7;18(8):e623–e638.
   PubMedGoogle Scholar
• Kucher N, Boekstegers P, Müller OJ, et al. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation. 2014 Jan 28;129(4):479–486.
   PubMed Web of Science ®Google Scholar
• Piazza G, Hohlfelder B, Jaff MR, et al. A prospective, single-arm, multicenter trial of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis for acute massive and submassive pulmonary embolism: the Seattle II study. JACC Cardiovasc Interv. 2015 Aug 24;8(10):1382–1392.
   PubMed Web of Science ®Google Scholar
• Tapson VF, Sterling K, Jones N, et al. A Randomized trial of the optimum duration of acoustic pulse thrombolysis procedure in acute intermediate-risk pulmonary embolism: the OPTALYSE PE trial. JACC Cardiovasc Interv. 2018 Jul 23;11(14):1401–1410.
   PubMed Web of Science ®Google Scholar
• Avgerinos ED, Jaber W, Lacomis J, et al. Randomized trial comparing standard versus ultrasound-assisted thrombolysis for submassive pulmonary embolism: the SUNSET sPE trial. JACC Cardiovasc Interv. 2021 Jun 28;14(12):1364–1373.
   PubMedGoogle Scholar
• Sista AK, Horowitz JM, Tapson VF, et al. Indigo aspiration system for treatment of pulmonary embolism: results of the EXTRACT-PE trial. JACC Cardiovasc Interv. 2021 Feb 8;14(3):319–329.
   PubMed Web of Science ®Google Scholar
• Tu T, Toma C, Tapson VF, et al. A prospective, single-arm, multicenter trial of catheter-directed mechanical thrombectomy for intermediate-risk acute pulmonary embolism: the FLARE study. JACC Cardiovasc Interv. 2019 May 13;12(9):859–869.
   PubMed Web of Science ®Google Scholar
• Klok FA, Piazza G, Sharp ASP, et al. Ultrasound-facilitated, catheter-directed thrombolysis vs anticoagulation alone for acute intermediate-high-risk pulmonary embolism: rationale and design of the HI-PEITHO study. Am Heart J. 2022 Sep;251:43–53.
   PubMed Web of Science ®Google Scholar
• The PEERLESS Study. https://ClinicalTrials.gov/show/NCT05111613.
   Google Scholar
• Meneveau N, Séronde MF, Blonde MC, et al. Management of unsuccessful thrombolysis in acute massive pulmonary embolism. Chest. 2006 Apr;129(4):1043–1050.
   PubMed Web of Science ®Google Scholar
• den Exter PL, Kroft LJM, Gonsalves C, et al. Establishing diagnostic criteria and treatment of subsegmental pulmonary embolism: a Delphi analysis of experts. Res Pract Thromb Haemost. 2020 Nov;4(8):1251–1261.
   PubMedGoogle Scholar
• Wiener RS, Schwartz LM, Woloshin S. Time trends in pulmonary embolism in the United States: evidence of overdiagnosis. Arch Intern Med. 2011 May 9;171(9):831–837.
   PubMedGoogle Scholar
• Wiener RS, Schwartz LM, Woloshin S. When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. Bmj. 2013 Jul 2;347(jul02 2):f3368.
   PubMedGoogle Scholar
• Carrier M, Klok FA. Symptomatic subsegmental pulmonary embolism: to treat or not to treat? Hematol Am Soc Hematol Educ Program. 2017 Dec 8;2017(1):237–241.
   PubMed Web of Science ®Google Scholar
• den Exter PL, van Es J, Klok FA, et al. Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism. Blood. 2013 Aug 15;122(7):1144–1149. quiz 1329
   PubMed Web of Science ®Google Scholar
• Swan D, Hitchen S, Klok FA, et al. The problem of under-diagnosis and over-diagnosis of pulmonary embolism. Thromb Res. 2019 May;177:122–129.
   PubMedGoogle Scholar
• van der Pol LM, Bistervels IM, van Mens TE, et al. Lower prevalence of subsegmental pulmonary embolism after application of the YEARS diagnostic algorithm. Br J Haematol. 2018 Nov;183(4):629–635.
   PubMedGoogle Scholar
• Goodman LR. Small pulmonary emboli: what do we know? Radiology. 2005 Mar;234(3):654–658.
   PubMedGoogle Scholar
• Ghanima W, Nielssen BE, Holmen LO, et al. Multidetector computed tomography (MDCT) in the diagnosis of pulmonary embolism: interobserver agreement among radiologists with varied levels of experience. Acta Radiol. 2007 Mar;48(2):165–170.
   PubMed Web of Science ®Google Scholar
• Pena E, Kimpton M, Dennie C, et al. Difference in interpretation of computed tomography pulmonary angiography diagnosis of subsegmental thrombosis in patients with suspected pulmonary embolism. J Thromb Haemost. 2012 Mar;10(3):496–498.
   PubMedGoogle Scholar
• Miller WT Jr., Marinari LA, Barbosa E Jr., et al. Small pulmonary artery defects are not reliable indicators of pulmonary embolism. Ann Am Thorac Soc. 2015 Jul;12(7):1022–1029.
   PubMed Web of Science ®Google Scholar
• Gurney JW. No fooling around: direct visualization of pulmonary embolism. Radiology. 1993 Sep;188(3):618–619.
   PubMedGoogle Scholar
• Schoepf UJ, Costello P. CT angiography for diagnosis of pulmonary embolism: state of the art. Radiology. 2004 Feb;230(2):329–337.
   PubMedGoogle Scholar
• Goy J, Lee J, Levine O, et al. Sub-segmental pulmonary embolism in three academic teaching hospitals: a review of management and outcomes. J Thromb Haemost. 2015 Feb;13(2):214–218.
   PubMedGoogle Scholar
• Mehta D, Barnett M, Zhou L, et al. Management and outcomes of single subsegmental pulmonary embolus: a retrospective audit at North Shore Hospital, New Zealand. Intern Med J. 2014 Sep;44(9):872–876.
   PubMedGoogle Scholar
• Donato AA, Khoche S, Santora J, et al. Clinical outcomes in patients with isolated subsegmental pulmonary emboli diagnosed by multidetector CT pulmonary angiography. Thromb Res. 2010 Oct;126(4):e266–70.
   PubMed Web of Science ®Google Scholar
• Cha SI, Shin KM, Lee JW, et al. Clinical characteristics of patients with peripheral pulmonary embolism. Respiration. 2010;80(6):500–508.
   PubMedGoogle Scholar
• Eyer BA, Goodman LR, Washington L. Clinicians’ response to radiologists’ reports of isolated subsegmental pulmonary embolism or inconclusive interpretation of pulmonary embolism using MDCT. AJR Am J Roentgenol. 2005 Feb;184(2):623–628.
   PubMed Web of Science ®Google Scholar
• Le Gal G, Kovacs MJ, Bertoletti L, et al. Risk for recurrent venous thromboembolism in patients with subsegmental pulmonary embolism managed without anticoagulation. Ann Intern Med. 2021 [2022 Jan 18];175(1):29–35.
   PubMedGoogle Scholar
• van der Hulle T, den Exter PL, Planquette B, et al. Risk of recurrent venous thromboembolism and major hemorrhage in cancer-associated incidental pulmonary embolism among treated and untreated patients: a pooled analysis of 926 patients. J Thromb Haemost. 2016 Jan;14(1):105–113.
   PubMedGoogle Scholar
• Prandoni P, Noventa F, Ghirarduzzi A, et al. The risk of recurrent venous thromboembolism after discontinuing anticoagulation in patients with acute proximal deep vein thrombosis or pulmonary embolism. A prospective cohort study in 1,626 patients. Haematologica. 2007 Feb;92(2):199–205.
   PubMed Web of Science ®Google Scholar
• Iorio A, Kearon C, Filippucci E, et al. Risk of recurrence after a first episode of symptomatic venous thromboembolism provoked by a transient risk factor: a systematic review. Arch Intern Med. 2010 Oct 25;170(19):1710–1716.
   PubMedGoogle Scholar
• den Exter PL, Kroft LJ, van der Hulle T, et al. Embolic burden of incidental pulmonary embolism diagnosed on routinely performed contrast-enhanced computed tomography imaging in cancer patients. J Thromb Haemost. 2013 Aug;11(8):1620–1622.
   PubMedGoogle Scholar
• den Exter PL, van der Hulle T, Hartmann IJ, et al. Reliability of diagnosing incidental pulmonary embolism in cancer patients. Thromb Res. 2015 Sep;136(3):531–534.
   PubMedGoogle Scholar
• Klok FA, Huisman MV. Management of incidental pulmonary embolism. Eur Respir J. 2017 Jun;49(6):1700275.
   PubMed Web of Science ®Google Scholar
• Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016 Feb;149(2):315–352.
   PubMed Web of Science ®Google Scholar
• Stein PD, Goodman LR, Hull RD, et al. Diagnosis and management of isolated subsegmental pulmonary embolism: review and assessment of the options. Clin Appl Thromb Hemost. 2012 January-February;18(1):20–26.
   PubMed Web of Science ®Google Scholar
• Jiménez D, Aujesky D, Díaz G, et al. Prognostic significance of deep vein thrombosis in patients presenting with acute symptomatic pulmonary embolism. Am J Respir Crit Care Med. 2010 May 1;181(9):983–991.
   PubMed Web of Science ®Google Scholar
• Baumgartner C, Klok FA, Carrier M, et al. Clinical Surveillance vs. Anticoagulation For low-risk patiEnts with isolated SubSegmental Pulmonary Embolism: protocol for a multicentre randomised placebo-controlled non-inferiority trial (SAFE-SSPE). BMJ Open. 2020;10(11):e040151.
   PubMedGoogle Scholar
• Aujesky D, Obrosky DS, Stone RA, et al. Derivation and validation of a prognostic model for pulmonary embolism. Am J Respir Crit Care Med. 2005 Oct 15;172(8):1041–1046.
   PubMed Web of Science ®Google Scholar
• Jiménez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010 Aug 9;170(15):1383–1389.
   PubMedGoogle Scholar
• Aujesky D, Roy PM, Verschuren F, et al. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. Lancet. 2011 Jul 2;378(9785):41–48.
   PubMed Web of Science ®Google Scholar
• Zondag W, Hiddinga BI, Crobach MJT, et al. Hestia criteria can discriminate high- from low-risk patients with pulmonary embolism. Eur Respir J. 2013;41(3):588–592.
   PubMedGoogle Scholar
• Zondag W, Mos IC, Creemers-Schild D, et al. Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study. J Thromb Haemost. 2011 Aug;9(8):1500–1507.
   PubMed Web of Science ®Google Scholar
• den Exter PL, Zondag W, Klok FA, et al. Efficacy and safety of outpatient treatment based on the Hestia clinical decision rule with or without N-terminal pro-brain natriuretic peptide testing in patients with acute pulmonary embolism. A randomized clinical trial. Am J Respir Crit Care Med. 2016 Oct 15;194(8):998–1006.
   PubMed Web of Science ®Google Scholar
• Roy PM, Penaloza A, Hugli O, et al. Triaging acute pulmonary embolism for home treatment by Hestia or simplified PESI criteria: the HOME-PE randomized trial. Eur Heart J. 2021 Aug 31;42(33):3146–3157.
   PubMedGoogle Scholar
• Barco S, Mahmoudpour SH, Planquette B, et al. Prognostic value of right ventricular dysfunction or elevated cardiac biomarkers in patients with low-risk pulmonary embolism: a systematic review and meta-analysis. Eur Heart J. 2019 Mar 14;40(11):902–910.
   PubMed Web of Science ®Google Scholar
• Barco S, et al. 2020. Early discharge and home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: an international multicentre single-arm clinical trial. Eur Heart J. 41(4):509–518. doi:10.1093/eurheartj/ehz367.
   PubMed Web of Science ®Google Scholar
• Hendriks SV, Klok FA, den Exter PL, et al. Right ventricle-to-left ventricle diameter ratio measurement seems to have no role in low-risk patients with pulmonary embolism treated at home triaged by Hestia criteria. Am J Respir Crit Care Med. 2020 Jul 1;202(1):138–141.
   PubMedGoogle Scholar
• Hendriks SV, Lankeit M, den Exter PL, et al. Uncertain value of high-sensitive troponin T for selecting patients with acute pulmonary embolism for outpatient treatment by Hestia criteria. Acad Emerg Med. 2020 Oct;27(10):1043–1046.
   PubMedGoogle Scholar
• Hendriks SV, Bavalia R, van Bemmel T, et al. Current practice patterns of outpatient management of acute pulmonary embolism: a post-hoc analysis of the YEARS study. Thromb Res. 2020 Sep;193:60–65.
   PubMedGoogle Scholar
• Hendriks SV, van den Hout WB, van Bemmel T, et al. Home treatment compared to initial hospitalization in normotensive patients with acute pulmonary embolism in the Netherlands: a cost analysis. Thromb Haemost. 2022 Mar;122(3):427–433.
   PubMedGoogle Scholar
• Bledsoe JR, Woller SC, Stevens SM, et al. Management of low-risk pulmonary embolism patients without hospitalization: the low-risk pulmonary embolism prospective management study. Chest. 2018 Aug;154(2):249–256.
   PubMed Web of Science ®Google Scholar
• Sista AK, Miller LE, Kahn SR, et al. Persistent right ventricular dysfunction, functional capacity limitation, exercise intolerance, and quality of life impairment following pulmonary embolism: systematic review with meta-analysis. Vasc Med. 2017 Feb;22(1):37–43.
   PubMed Web of Science ®Google Scholar
• Klok FA, Barco S. Follow-up after acute pulmonary embolism. Hamostaseologie. 2018 Feb;38(1):22–32.
   PubMedGoogle Scholar
• Klok FA, van der Hulle T, den Exter PL, et al. The post-PE syndrome: a new concept for chronic complications of pulmonary embolism. Blood Rev. 2014 Nov;28(6):221–226.
   PubMed Web of Science ®Google Scholar
• Boon GJAM, Huisman MV, Klok FA. Determinants and management of the post-pulmonary embolism syndrome. Semin Respir Crit Care Med. 2021 Feb 6;42(2):299–307.
   PubMedGoogle Scholar
• Klok FA, Ageno W, Ay C, et al. Optimal follow-up after acute pulmonary embolism: a position paper of the European Society of Cardiology Working Group on Pulmonary Circulation and Right Ventricular Function, in collaboration with the European Society of Cardiology Working Group on Atherosclerosis and Vascular Biology, endorsed by the European Respiratory Society. Eur Heart J. 2022 Jan 25;43(3):183–189.
   PubMedGoogle Scholar
• Kahn SR, Hirsch AM, Akaberi A, et al. Functional and exercise limitations after a first episode of pulmonary embolism: results of the ELOPE prospective cohort study. Chest. 2017 May;151(5):1058–1068.
   PubMed Web of Science ®Google Scholar
• Klok FA, van Kralingen KW, van Dijk AP, et al. Prevalence and potential determinants of exertional dyspnea after acute pulmonary embolism. Respir Med. 2010 Nov;104(11):1744–1749.
   PubMedGoogle Scholar
• Le Gal GCM, Castellucci LA, Castellucci LA, et al. for the ISTHCDE Task Force. Development and implementation of common data elements for venous thromboembolism research: officialCommunication from the SSC of the ISTH. J Thromb Haemost. 2021;19(1):297–303.
   PubMedGoogle Scholar
• Boon G, Bogaard HJ, Klok FA. Essential aspects of the follow-up after acute pulmonary embolism: an illustrated review. Res Pract Thromb Haemost. 2020 Aug;4(6):958–968.
   PubMed Web of Science ®Google Scholar
• Klok FA, Barco S, Konstantinides SV, et al. Determinants of diagnostic delay in chronic thromboembolic pulmonary hypertension: results from the European CTEPH Registry. Eur Respir J. 2018 Dec;52(6):1801687.
   PubMed Web of Science ®Google Scholar
• Guérin L, Couturaud F, Parent F, et al. Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Prevalence of CTEPH after pulmonary embolism. Thromb Haemost. 2014 Sep 2;112(3):598–605.
   PubMed Web of Science ®Google Scholar
• Klok FA, Barco S, Siegerink B. Measuring functional limitations after venous thromboembolism: a call to action. Thromb Res. 2019 Jun;178:59–62.
   PubMedGoogle Scholar
• Boon GJAM, Barco S, Bertoletti L, et al. Measuring functional limitations after venous thromboembolism: optimization of the Post-VTE Functional Status (PVFS) Scale. Thromb Res. 2020 Jun;190:45–51.
   PubMed Web of Science ®Google Scholar
• Gwozdz AM, de Jong CMM, Fialho LS, et al. Development of an international standard set of outcome measures for patients with venous thromboembolism: an International Consortium for Health Outcomes Measurement consensus recommendation. Lancet Haematol. 2022 Sep 01;9(9):e698–e706.
   PubMedGoogle Scholar
• Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J. 2020 Dec 17;57(6):2002828.
   Google Scholar
• Boon GJAM, van den Hout WB, Barco S, et al. A model for estimating the health economic impact of earlier diagnosis of chronic thromboembolic pulmonary hypertension. ERJ Open Res. 2021;7(3):00719–2020.
   PubMedGoogle Scholar
• Humbert M, Kovacs G, Hoeper MM, et al. ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J. 2022;43(38):3618–3731.
   PubMed Web of Science ®Google Scholar
• Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J. 2021 Jun;57(6):2002828.
   PubMed Web of Science ®Google Scholar
• Klok FA, Surie S, Kempf T, et al. A simple non-invasive diagnostic algorithm for ruling out chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. Thromb Res. 2011 Jul;128(1):21–26.
   PubMed Web of Science ®Google Scholar
• Klok FA, Dzikowska‐Diduch O, Kostrubiec M, et al. Derivation of a clinical prediction score for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. J Thromb Haemost. 2016 Jan;14(1):121–128.
   PubMed Web of Science ®Google Scholar
• Boon G, Ende-Verhaar YM, Bavalia R, et al. Non-invasive early exclusion of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: the InShape II study. Thorax. Published Online First 2021 Mar 23.
   Google Scholar
• Ende-Verhaar YM, Huisman MV, Klok FA. To screen or not to screen for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Thromb Res. 2017 Mar;151:1–7.
   PubMed Web of Science ®Google Scholar
• Ende-Verhaar YM, Ruigrok D, Bogaard HJ, et al. Sensitivity of a simple noninvasive screening algorithm for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. TH Open. 2018 Jan;2(1):e89–e95.
   PubMedGoogle Scholar
• Ende-Verhaar YM, Meijboom LJ, Kroft LJM, et al. Usefulness of standard computed tomography pulmonary angiography performed for acute pulmonary embolism for identification of chronic thromboembolic pulmonary hypertension: results of the InShape III study. J Heart Lung Transplant. 2019 Jul;38(7):731–738.
   PubMed Web of Science ®Google Scholar
• Boon G, Jairam PM, Groot GMC, et al. Identification of chronic thromboembolic pulmonary hypertension on CTPAs performed for diagnosing acute pulmonary embolism depending on level of expertise. Eur J Intern Med. 2021 Jul;93:64–70.
   PubMedGoogle Scholar
• Boon G, Ende-Verhaar YM, Beenen LFM, et al. Prediction of chronic thromboembolic pulmonary hypertension with standardised evaluation of initial computed tomography pulmonary angiography performed for suspected acute pulmonary embolism. Eur Radiol. 2022 Apr;32(4):2178–2187.
   PubMedGoogle Scholar
• Braams NJ, Boon G, de Man FS, et al. Evolution of CT findings after anticoagulant treatment for acute pulmonary embolism in patients with and without an ultimate diagnosis of chronic thromboembolic pulmonary hypertension. Eur Respir J. 2021 Dec;58(6):2100699.
   PubMedGoogle Scholar
• Albaghdadi MS, Dudzinski DM, Giordano N, et al. Cardiopulmonary exercise testing in patients following massive and submassive pulmonary embolism. J Am Heart Assoc. 2018 Mar 3;7(5). DOI:10.1161/JAHA.117.006841.
   PubMedGoogle Scholar
• Kirchberger I, Ruile S, Linseisen J, et al. The lived experience with pulmonary embolism: a qualitative study using focus groups. Respir Med. 2020 Jun;167:105978.
   PubMedGoogle Scholar
• Danielsbacka JS, Rostberg L, Olsén MF, et al. “Whole life changed” - experiences of how symptoms derived from acute pulmonary embolism affects life. A qualitative interview study. Thromb Res. 2021 Sep;205:56–62.
   PubMedGoogle Scholar
• Boon GJAM, Janssen SMJ, Barco S, et al. Efficacy and safety of a 12-week outpatient pulmonary rehabilitation program in Post-PE Syndrome. Thromb Res. 2021 Aug 17;206:66–75.
   PubMedGoogle Scholar
• Nopp S, Klok FA, Moik F, et al. Outpatient pulmonary rehabilitation in patients with persisting symptoms after pulmonary embolism. J Clin Med. 2020 Jun 10;9(6):1811.
   PubMed Web of Science ®Google Scholar
• Cires-Drouet RS, Mayorga-Carlin M, Toursavadkohi S, et al. Safety of exercise therapy after acute pulmonary embolism. Phlebology. 2020 Jul 27;35(10):824–832.
   PubMedGoogle Scholar
• Rolving N, Brocki BC, Bloch-Nielsen JR, et al. Effect of a physiotherapist-guided home-based exercise intervention on physical capacity and patient-reported outcomes among patients with acute pulmonary embolism: a randomized clinical trial. JAMA network open. 2020 Feb 5;3(2):e200064.
   PubMedGoogle Scholar
• Amoury M, Noack F, Kleeberg K, et al. Prognosis of patients with pulmonary embolism after rehabilitation. Vasc Health Risk Manag. 2018;14:183–187.
   PubMed Web of Science ®Google Scholar
• Noack F, Schmidt B, Amoury M, et al. Feasibility and safety of rehabilitation after venous thromboembolism. Vasc Health Risk Manag. 2015;11:397–401.
   PubMed Web of Science ®Google Scholar
• Lakoski SG, Savage PD, Berkman AM, et al. The safety and efficacy of early-initiation exercise training after acute venous thromboembolism: a randomized clinical trial. J Thromb Haemost. 2015 Jul;13(7):1238–1244.
   PubMed Web of Science ®Google Scholar
• Ghram A, Jenab Y, Soori R, et al. High-intensity interval training in patients with pulmonary embolism: a randomized controlled trial. Med Sci Sports Exerc. 2021;53(10):2037–2044.
   PubMedGoogle Scholar