CTA Chest With IV Contrast with CTV Lower Extremities The literature does not support the use of CTA chest with IV contrast with CT venography (CTV) lower extremities for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12- 16]. The use of CTA for alternate diagnoses is beyond the scope of this document. Suspected Pulmonary Embolism Arteriography Pulmonary with Right Heart Catheterization Pulmonary angiography, including right heart catheterization and measurement of pulmonary artery and right heart pressures, is almost never used as a first-line test for PE, although it had historic diagnostic use [17-19] before it was supplanted by CTPA. The overall accuracy of catheter pulmonary angiography is likely to be inferior to CTPA. The role of angiography, when therapy such as pulmonary embolectomy is performed, is not within the scope of this document. This is in keeping with evidence suggesting that advanced imaging is not supported for patients included in Variant 1 [8,12-16]. MRA Pulmonary Arteries Without and With IV Contrast The literature does not support the use of MR angiography (MRA) pulmonary arteries without and with IV contrast for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12- 16]. MRA Pulmonary Arteries Without IV Contrast The literature does not support the use of MRA pulmonary arteries without IV contrast for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12-16]. US Duplex Doppler Lower Extremity The literature does not support the use of ultrasound (US) duplex Doppler lower extremity for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12-16].
Suspected Pulmonary Embolism PCAs. CTA Chest With IV Contrast with CTV Lower Extremities The literature does not support the use of CTA chest with IV contrast with CT venography (CTV) lower extremities for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12- 16]. The use of CTA for alternate diagnoses is beyond the scope of this document. Suspected Pulmonary Embolism Arteriography Pulmonary with Right Heart Catheterization Pulmonary angiography, including right heart catheterization and measurement of pulmonary artery and right heart pressures, is almost never used as a first-line test for PE, although it had historic diagnostic use [17-19] before it was supplanted by CTPA. The overall accuracy of catheter pulmonary angiography is likely to be inferior to CTPA. The role of angiography, when therapy such as pulmonary embolectomy is performed, is not within the scope of this document. This is in keeping with evidence suggesting that advanced imaging is not supported for patients included in Variant 1 [8,12-16]. MRA Pulmonary Arteries Without and With IV Contrast The literature does not support the use of MR angiography (MRA) pulmonary arteries without and with IV contrast for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12- 16]. MRA Pulmonary Arteries Without IV Contrast The literature does not support the use of MRA pulmonary arteries without IV contrast for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12-16]. US Duplex Doppler Lower Extremity The literature does not support the use of ultrasound (US) duplex Doppler lower extremity for the evaluation of suspected PE for patients with low to intermediate probability and negative D-dimer [8,12-16].