, Volume 19, Issue 1, pp 77–90

Aktuelle Therapie und Sekundärprävention der Lungenembolie

CME Zertifizierte Fortbildung


Die Strategien zur Risikostratifizierung und risikoadaptierten Diagnostik und Therapie von Patienten mit Lungenembolie befinden sich aktuell in einer Phase des Umbruchs. Für die neuen europäischen Leitlinien, die im Jahr 2014 erscheinen sollen, werden umfangreiche Veränderungen insbesondere im Bereich der Indikation zur Thrombolyse bei normotensiven Patienten mit „intermediärem“ Risiko, der interventionellen Hybridverfahren zur pharmakomechanischen lokalen Thrombolyse, der neuen oralen Antikoagulanzien zur Therapie und (verlängerten) Sekundärprophylaxe, der möglichen Indikation von Azetylsalizylsäure zur verlängerten Sekundärprophylaxe sowie der ambulanten Behandlung von Patienten mit „niedrigem“ Risiko erwartet. In diesem Artikel werden die aktuellen Leitlinien zur Therapie und Sekundärprävention der Lungenembolie sowie die aktuelle klinische Studienlage und deren mögliche Implikationen für die Therapie und die Sekundärprävention der Lungenembolie zusammengefasst.


Risikostratifizierung Thrombolyse Neue orale Antikoagulanzien Azetylsalizylsäure Ambulante Behandlung 

Current therapy and secondary prophylaxis of pulmonary embolism


Currently strategies for risk stratification and risk-adjusted diagnostics and management algorithms of patients with pulmonary embolism are undergoing considerable progress and transition. For the new European guidelines expected in 2014, extensive changes are expected in the areas of (1) thrombolysis of normotensive patients with intermediate risk, (2) interventional ultrasound-enhanced low-dose catheter-derived (pharmacomechanical) local thrombolysis, (3) novel oral anticoagulants for therapy and (extended) secondary prophylaxis, (4) possible indications of low-dose aspirin for extended secondary prophylaxis and (5) home treatment of patients with low risk pulmonary embolism. This article summarizes the current guidelines for therapy and secondary prophylaxis of pulmonary embolism and novel clinical studies and the possible implications for therapy and secondary prophylaxis of pulmonary embolism.


Risk stratification Thrombolysis Novel oral anticoagulants Acetylsalicylic acid Home treatment 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Centrum für Thrombose und Hämostase (CTH)Universitätsmedizin der Johannes-Gutenberg-Universität MainzMainzDeutschland

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