Massive occlusion of the main pulmonary artery and primary branches; case report.

[ASSIVE occlusion of the main pulmonary artery and its primary branches is believed seldom compatible with prolonged survival. However, a number of reports exist indicating a duration of from several months to several years. No documented cases were found to compare, either in length of life after the episode or in degree of pulmonary artery occlusion, with our patient who survived about 6 years. Chronic obstruction of the major pulmonary arteries with cor pulmonale has been reported as a clinical syndrome more frequently in recent years.'-4 The cause of pulmonary embolism seems directly related to peripheral vascular disease, namely, phlebothrombosis or possibly thrombophlebitis. Emboli are considered to be uncommon as a result of thrombophlebitis, but a red, swollen, tender extremity may represent phlebothrombosis rather than phlebitis, thus causing a misleading opinion regarding the origin of emboli and erroneously raising the frequency of embolism reported as due to thrombophlebitis. The total number of reported cases of long-standing pulmonary embolism may be less than 200 and the majority of these has been discovered at autopsy. No reports were found in which an antemortem diagnosis was made before 1940. This report is intended to call attention to 2 important phases of this condition. First the duration of life after the initial episode (1950)