Welcome to issue 16 of PERTinent Updates, featuring a select group of articles for your review. We aim to inform and update our members with the most recent major developments in the fields of PERT/VTE so that we in the PERT Consortium can continue to be at the leading edge of improving care for this vulnerable and overlooked group of patients.

New to this edition is Guidelines- a section dedicated to highlighting recommendations for clinical practice from a variety of professional societies and expert consensus. Best practice is still being defined in many areas of VTE care and, as such, guidelines can be a useful aid in supporting best clinical practice until research literature is more clearly defined.

Other articles from this month’s
From Our Own include…

• Changes in treatment and outcomes after creation of a pulmonary embolism response team (PERT), a 10-year analysis.
• Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography.
• Right Heart Thrombi: Patient Outcomes by Treatment Modality and Predictors of Mortality: A Pooled Analysis.

Guidelines

National Comprehensive Cancer Network: Cancer-Associated Venous Thromboembolic Disease guidelines.

Recently, the National Comprehensive Cancer Network (NCCN) updated their guidelines for Cancer-Associated VTE care. To access the guidelines, a free account will need to be established with NCCN. The PERTinent Updates team highly recommends this as a valuable resource for managing VTE in this challenging patient population. Once logged in to the NCCN site, click on “NCCN Guidelines-Free” under the Clinicians quick link column on the right side of the home page. The Cancer-Associated Venous Thromboembolic Disease guidelines are including under the “NCCN Guidelines for Supportive Care” heading.

Diagnosis

Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study.
Righini M, Robert-Ebadi H, Elias A, Sanchez O, Le Moigne E, Schmidt J, Le Gall C, Cornuz J, Aujesky D, Roy PM, Chauleur C, Rutschmann OT, Poletti PA, Le Gal G; CT-PE-Pregnancy Group.
Ann Intern Med. 2018 Oct 23. doi: 10.7326/M18-1670. [Epub ahead of print]
PMID: 30357273 [PubMed – as supplied by publisher]

Imaging

Comprehensive Imaging Assessment of Right Ventricular Strain in Acute Pulmonary Embolism.
Scagliola R, Brunelli C.
Am J Cardiol. 2018 Sep 8. pii: S0002-9149(18)31647-3. doi: 10.1016/j.amjcard.2018.07.050. [Epub ahead of print] No abstract available.
PMID: 30286943

Management- Transition of Care

Defining Minimum Necessary Anticoagulation-Related Communication at Discharge: Consensus of the Care Transitions

Task Force of the New York State Anticoagulation Coalition.
Triller D, Myrka A, Gassler J, Rudd K, Meek P, Kouides P, Burnett AE, Spyropoulos AC, Ansell J.
Jt Comm J Qual Patient Saf. 2018 Nov;44(11):630-640. doi: 10.1016/j.jcjq.2018.04.015. Epub 2018 Jul 24.
PMID: 30064950

Reviews & Meta-analysis

Differential impact of syncope on the prognosis of patients with acute pulmonary embolism: a systematic review and meta-analysis.
Barco S, Ende-Verhaar YM, Becattini C, Jimenez D, Lankeit M, Huisman MV, Konstantinides SV, Klok FA.
Eur Heart J. 2018 Oct 17. doi: 10.1093/eurheartj/ehy631. [Epub ahead of print]
PMID: 30339253 [PubMed – as supplied by publisher]

Optimal Therapy for Unstable Pulmonary Embolism.
Stein PD, Dalen JE, Matta F, Hughes MJ.
Am J Med. 2018 Oct 1. pii: S0002-9343(18)30941-0. doi: 10.1016/j.amjmed.2018.09.018. [Epub ahead of print] Review.
PMID: 30287238 [PubMed – as supplied by publisher]

From Our Own…

Changes in treatment and outcomes after creation of a pulmonary embolism response team (PERT), a 10-year analysis.
Rosovsky R, Chang Y, Rosenfield K, Channick R, Jaff MR, Weinberg I, Sundt T, Witkin A, Rodriguez-Lopez J, Parry BA, Harshbarger S, Hariharan P, Kabrhel C.
J Thromb Thrombolysis. 2018 Sep 21. doi: 10.1007/s11239-018-1737-8. [Epub ahead of print]
PMID: 30242551

Right Heart Thrombi: Patient Outcomes by Treatment Modality and Predictors of Mortality: A Pooled Analysis.
Islam M, Nesheim D, Acquah S, Kory P, Kourouni I, Ramesh N, Ehrlich M, Bajpayee G, Steiger D, Filopei J.
J Intensive Care Med. 2018 Oct 29:885066618808193. doi: 10.1177/0885066618808193. [Epub ahead of print]
PMID: 30373436

Portable Ventilation/Perfusion Scanning is Useful for Evaluating Clinically Significant Pulmonary Embolism in the ICU Despite Abnormal Chest Radiography.
Weinberg AS, Chang W, Ih G, Waxman A, Tapson VF.
J Intensive Care Med. 2018 Oct 22:885066618807859. doi: 10.1177/0885066618807859. [Epub ahead of print]
PMID: 30348044