Evaluation and Management of Intermediate and High-Risk Pulmonary Embolism

AJR Am J Roentgenol. 2020 Mar;214(3):671-678. doi: 10.2214/AJR.19.21861. Epub 2019 Nov 19.

Abstract

OBJECTIVE. The evidence regarding pulmonary embolism treatment has greatly advanced over the past 10 years, particularly in patients with right ventricular dysfunction or hemodynamic instability. Treatment options include systemic anticoagulation, systemic thrombolysis, catheter-assisted thrombus removal (mechanical with or without catheter-directed thrombolysis), and surgical embolectomy. CONCLUSION. This article will review the data available for treatment options and summarize the evidence-based guidelines on treatment of intermediate- or high-risk pulmonary embolism.

Keywords: catheter-directed thrombolysis; mechanical thrombectomy; pulmonary embolism; thrombolysis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diagnosis, Differential
  • Embolectomy
  • Evidence-Based Medicine
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Practice Guidelines as Topic
  • Pulmonary Embolism / diagnostic imaging*
  • Pulmonary Embolism / therapy*
  • Risk Assessment
  • Thrombolytic Therapy

Substances

  • Fibrinolytic Agents