Realizamos un estudio prospectivo para conocer la evolución de los defectos de perfusión a los 6 meses tras un tromboembolismo pulmonar (TEP), identificar aquellos factores asociados con su evolución y evaluar la incidencia de recurrencias subclínicas. Se incluyeron a 70 pacientes diagnosticados de TEP. Se practicó una gammagrafía pulmonar de perfusión a los 6 meses del episodio agudo de TEP. Los resultados se compararon con los defectos iniciales. Se buscaron relaciones significativas entre los distintos perfiles evolutivos y diferentes factores, tales como la edad, el sexo, el tratamiento anticoagulante y los antecedentes personales.
Los defectos gammagráficos persistieron idénticos al episodio inicial en 15 de los 70 pacientes (21%), disminuyeron en 37 (53%) y desaparecieron en su totalidad en 16 (23%). Se hallaron nuevos defectos en 2 casos.
Existió una relación significativa entre la evolución gammagráfica favorable y el cumplimiento del tratamiento anticoagulante (p=0,0024).
Otras relaciones con significación estadística fueron el perfil evolutivo favorable y el antecedente de intervención quirúrgica en el episodio agudo (p=0,004) y el perfil evolutivo desfavorable con el antecedente de enfermedad tromboembólica venosa (ETV) previa (p=0,004).
We performed a prospective study to determine the evolution of perfusion defects 6 months after pulmonary thromboembolism (PTE), to identify associated factors and to evaluate the incidence of subclinical recurrence.
Seventy patients diagnosed of PTE were enrolled. Perfusion pulmonary scintiscans were performed 6 months after the acute PTE episode and the results were compared with initial defects. We looked for significant relations between several course profiles and factors such as age, sex, anticoagulation therapy and patient history.
Defects revealed by the initial scintiscan remained the same 6 months later in 15 (21%), decreased in 35 (53%) and disappeared in 16 (23%) of the 70 patients. New defects were identified in 2 patients.
A significant relation was found between a favorable outcome as shown by follow-up scintiscans and compliance with anticoagulation therapy (p=0.0024).
Other statistically significant relations were observed between favorable outcome and a history of surgical intervention during the acute episode (p=0.004) and between unfavorable outcome and a history of venous thromboembolic disease (p=0.004).
