在所有诊断出的肺栓塞中，大约 10% 是孤立于亚段血管的。对于接受或不接受抗凝治疗的急性亚节段性肺栓塞 (SSPE) 患者，复发静脉血栓栓塞 (VTE) 的风险仍知之甚少。这是一项观察性队列研究，包括 2019 年 6 月 1 日期间诊断为急性孤立性 SSPE 的连续成年患者，和2022年8月31日。我们排除了同时诊断为深静脉血栓的患者和有长期抗凝指征的患者。主要结局是客观证实复发性 VTE。总体而言，分析纳入了 118 名急性 SSPE 患者。参与者的平均年龄（±标准差 [SD]）为 59 ± 17 岁，其中 44% 患有活动性癌症。平均 (±SD) 随访时间为 438 ± 426 天。 77 名患者 (65%) 最初接受了抗凝治疗，而 41 名患者 (35%) 则没有接受抗凝治疗。在接受抗凝治疗的 77 名患者中，23 名 (30%) 接受了长期抗凝治疗（超过 3 个月）以进行二级预防。总体而言，6/118（5%，95% CI 2.4 至 10.7）患者发生复发性 VTE 事件。最初接受治疗的患者中发生了四起事件（4/77 = 5.2%，95% CI 2.0 至 12.6）。最初未接受治疗的患者发生了两次复发性 VTE（2/41 = 4.9%，95% CI 1.4 至 16.1）。一半的复发性 VTE 发生在患有活动性癌症的患者中。大多数诊断为急性 SSPE 的患者接受了抗凝治疗。随着时间的推移，检测到的复发性 VTE 发生率相对较高，尤其是癌症患者。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Approximately 10 % of all diagnosed pulmonary embolism are isolated to the subsegmental vessels. The risk of recurrent venous thromboembolism (VTE) in patients with an acute subsegmental pulmonary embolism (SSPE) managed with or without anticoagulant therapy remains poorly understood.This is an observational cohort study including consecutive adult patients diagnosed with acute isolated SSPE between June 01, 2019, and August 31, 2022. We excluded patients with a concomitant diagnosis of deep vein thrombosis and those who had an indication for long-term anticoagulation. The primary outcome was objectively confirmed recurrent VTE.Overall, 118 patients with acute SSPE were included in the analysis. The mean (± standard deviation [SD]) age of the participants was 59 ± 17 years and 44 % of them had active cancer. Mean (±SD) duration of follow-up was 438 ± 426 days. Seventy-seven patients (65 %) were initially treated with anticoagulation, whereas 41 patients (35 %) were not. Of the 77 patients receiving anticoagulant therapy, 23 (30 %) received extended-duration anticoagulation (beyond 3 months) for secondary prevention. Overall, recurrent VTE events occurred in 6/118 (5 %, 95 % CI 2.4 to 10.7) patients. Four events (4/77 = 5.2 %, 95 % CI 2.0 to 12.6) occurred in initially treated patients. Two recurrent VTE occurred in patients initially left untreated (2/41 = 4.9 %, 95 % CI 1.4 to 16.1). Half of the recurrent VTE occurred in patients with active cancer.Most patients diagnosed with an acute SSPE received anticoagulation. The incidence of recurrent VTE detected over time was relatively high, especially in patients with cancer.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.