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September 12, 1966

Conservative Treatment of Massive Pulmonary Embolism

Author Affiliations

From the Marshfield Clinic and Marshfield Clinic Foundation for Medical Research and Education. Marshfield, Wis.

JAMA. 1966;197(11):924-926. doi:10.1001/jama.1966.03110110148043

SPONTANEOUS resolution of massive pulmonary embolism has been reported.1 Important questions, however, remain to be answered. Do these emboli produce a permanent change in pulmonary function and pulmonary vascular resistance? Is pulmonary embolectomy ever indicated except as a life-saving procedure? What procedures are necessary to prevent further embolization? How rapidly does resolution of. the emboli take place? It is apparent that a large body of information is a necessity before these problems can be solved.

In the case to be reported the large emboli present in the main pulmonary artery and its right and left branches resolved spontaneously. Four pulmonary angiograms were performed providing adequate roentgen demonstration of the emboli and their resolution. Subsequent pulmonary-function studies failed to reveal any adverse effect of the massive emboli.

Report of a Case  A 40-year-old white man suffered a fracture of his left tibia and fibula on Nov 9, 1964. Seven days