Abstract
Background: A saddle pulmonary embolism (SPE) occurs when a blood clot blocks the main pulmonary artery or extends into both main pulmonary arteries. SPE is considered a non-fatal disease in some articles; however, recent research suggests that it could be a life-threatening condition. Treatment of patients with heparin or fibrinolytics depends on the prognostic evaluation of patients. This review study was conducted to address the controversy between different articles.
Methods: In this review, international databases, including PubMed, Scopus, and Web of Science, were searched for relevant studies. Finally, related articles were selected and included in the study using titles and abstracts.
Results: Based on the results, a total of 13 articles had prognostic evaluations for SPE. Among these articles, 5 articles suggested that SPE did not increase patient mortality, 5 articles suggested SPE as a prognostic factor for adverse events including higher mortality, and 3 articles did not show higher short-term mortality but reported some adverse events. Additionally, 9 articles were selected for new treatments. This review revealed a significant controversy between articles, indicating that further investigations should be conducted in this area, focusing on the size of the clot, its extension, and the comorbidities of patients.
Conclusion: It appears that hemodynamic changes on admission and during hospitalization are more important than the pure diagnosis of SPE in predicting patients’ outcomes.