Risk Stratification and Management of Intermediate- and High-Risk Pulmonary Embolism.

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Manuscript

Publication Date

9-20-2024

Keywords

catheter-directed embolectomy, catheter-directed thrombolysis, pulmonary embolism, systemic thrombolysis, venous thromboembolism

Disciplines

Cardiovascular Diseases | Internal Medicine | Medicine and Health Sciences

Abstract

Acute pulmonary embolism (PE) is a leading cause of mortality. Not only is PE associated with short-term mortality, but up to ~20% of patients might suffer from long-term consequences such as post-PE syndrome and chronic thromboembolic pulmonary hypertension. Current risk stratification tools poorly predict those who are at risk for short-term deterioration and those who develop long-term consequences. Traditionally, systemic thrombolysis has been considered the first-line therapy for patients with high-risk PE without contraindications; however, it comes with the risk of major bleeding (notably intracranial hemorrhage). The use of catheter-directed interventions (embolectomy or thrombolysis) has been increasing owing to their low bleeding risk; however, randomized trial data supporting their efficacy in improving clinical outcomes are limited. In this review, we highlight the evidence supporting the available advanced therapies for high- and intermediate-risk PE and summarize the ongoing trials which are evaluating these therapies.

Publisher or Conference

Journal of Clinical Medicine

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