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An Update on the Management of Acute High-Risk Pulmonary Embolism.

ABSTRACT: Hemodynamic instability and right ventricular (RV) dysfunction are the key determinants of short-term prognosis in patients with acute pulmonary embolism (PE). High-risk PE encompasses a wide spectrum of clinical situations from sustained hypotension to cardiac arrest. Early recognition and treatment tailored to each individual are crucial. Systemic fibrinolysis is the first-line pulmonary reperfusion therapy to rapidly reverse RV overload and hemodynamic collapse, at the cost of a significant rate of bleeding. Catheter-directed pharmacological and mechanical techniques ensure swift recovery of echocardiographic parameters and may possess a better safety profile than systemic thrombolysis. Further clinical studies are mandatory to clarify which pulmonary reperfusion strategy may improve early clinical outcomes and fill existing gaps in the evidence.

SUBMITTER: Chopard R

PROVIDER: S-EPMC9409943 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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An Update on the Management of Acute High-Risk Pulmonary Embolism.

Chopard Romain R Behr Julien J Vidoni Charles C Ecarnot Fiona F Meneveau Nicolas N

Journal of clinical medicine 20220817 16

Hemodynamic instability and right ventricular (RV) dysfunction are the key determinants of short-term prognosis in patients with acute pulmonary embolism (PE). High-risk PE encompasses a wide spectrum of clinical situations from sustained hypotension to cardiac arrest. Early recognition and treatment tailored to each individual are crucial. Systemic fibrinolysis is the first-line pulmonary reperfusion therapy to rapidly reverse RV overload and hemodynamic collapse, at the cost of a significant r ...[more]

PMID: 36013046

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