Saddle embolism

These images from a CT pulmonary angiogram (CTPA) show a saddle embolism. This is a large PE that extends across the bifurcation of the main pulmonary artery (left image, arrows). Further PEs, manifesting as ‘filling defects’ in the otherwise contrast-filled arteries, are demonstrated on the image on the right, arrows. Large emboli like these, in the proximal pulmonary arterial tree, can cause acute right heart failure and death.