[Diagnosis of pulmonary embolism and monitoring of post-embolic changes in the vessels using pulmonary digital subtraction angiography].
The group comprises 48 patients where digital subtraction angiography revealed embolization of the lungs. Forty-four of the patients were examined on account of clinical suspicion of embolism of the lungs, in the remaining four the examination was made on account of other indications. In four instances of 48 patients where we diagnosed or suspected embolism of the lungs DSA was also used to follow up the effect of heparinization and anti-aggregation therapy in relatively extensive findings revealed during the first examination. Based on their experience, the authors summarize angiographic pictures into four morphological types: perfusion defect, localized thinning and reduction of peripheral arterioles, sudden discontinuation of lobar and segmental arteries ("cut-off") and intraluminal defects in the contrast filling of arteries. The authors evaluate objectively the advantages and disadvantages of DSA and compare in the discussion the course of the examination, as well as the results with classical angiography, with perfusion and ventilation scan and try to find the correct place in the algorithm of visualization methods when embolism of the lungs is suspected. Based on the assembled experience, DSA of the lungs can be used as the first diagnostic method or after screening perfusion scan, if the latter is available immediately after development of complaints, as the second method. The authors analyze also the reasons of the relatively less frequent and very often late indication of this examination in this country.