Aggressive Therapy for Acute Pulmonary Embolism: Systemic Thrombolysis and Catheter-Directed Approaches

Semin Respir Crit Care Med. 2021 Apr;42(2):250-262. doi: 10.1055/s-0040-1722291. Epub 2021 Feb 6.

Abstract

Venous thromboembolism (VTE) is the third most common cause of cardiovascular disease after myocardial infarction and stroke. Population-based studies estimate that up to 94,000 new cases of pulmonary embolism (PE) occur in the United States annually with an increasing incidence with age. Mortality from PE is the greatest in the first 24 hours, with a decreased survival extending out 3 months. Thus, acute PE is a potentially fatal illness if not recognized and treated in a timely manner. Contemporary management includes systemic anticoagulation, thrombolysis, catheter-based procedures, and surgical embolectomy. This article reviews current clinical evidence and societal guidelines for the use of systemic and catheter-directed thrombolysis for treatment of acute PE.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Catheters
  • Fibrinolytic Agents
  • Humans
  • Pulmonary Embolism* / drug therapy
  • Risk Factors
  • Thrombolytic Therapy*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents