Pulmonary embolism (PE) associated with urological surgery and angiography

As a result of the Westernization of life style in Japan, the incidence of pulmonary embolism (PE) has been increasing, mainly after surgery and vessel catheterization. We encountered 4 cases of PE associated with urological surgery and angiography during the 3 and half years since 1995; one occurred after nephrouretectomy, one after TUR-P, and two after abdominal angiography. Three patients recovered from PE, but the other is still on a respirator. As risk factors of PE, 3 patients were over 60 years old, one was obese, two had hypertension, and one had atrial fibrillation (Af). Three patients were given tranexamic acid (AMCA). Prophylactic procedures against PE, such as intermittent compression devices for the lower extremities and low-molecule heparinization, are recommended for high-risk patients. AMCA should be used with care in patients who undergo surgery and angiography.