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Current Management of Acute Pulmonary Embolism

  • Vascular Surgery (S Toursavadkohi, Section Editor )
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Abstract

Purpose of Review

The purpose of this review article is to analyze the current information about diagnosis, prognosis, treatment, and interventional therapies regarding pulmonary embolism (PE) treatment. In addition to review the outcomes obtained by pulmonary embolism response teams.

Recent Findings

Several important contributions in the PE management have been recently published. New scoring systems, such as the PERC rule and YEARS, are used to effectively rule out PE; and stratification scores such as Bova and Hestia were validated. New evidence was favorable to support the use of direct oral anticoagulants in morbidly obese and end-stage renal disease patients; although, not in patients with antiphospholipid antibody syndrome. New studies of catheter-based thrombectomy for acute PE were also published. However, a new statement from the American Heart Association criticizes the lack of randomized trials to support the use of catheter-based interventions in acute PE. Contributions about the cardiopulmonary support in massive PE patients, including ventilation techniques, vasopressors, inhaled pulmonary vasodilators and extracorporeal membrane oxygenation are available. Finally, the advantages and disadvantages of the impact of Pulmonary Embolism Response Teams in the care of acute PE patients.

Summary

Nearly all aspects in the diagnosis, prognosis and care of PE are evolving. In this article, we discuss the epidemiology, diagnosis, risk stratification, and therapeutic approaches to PE. We provide additional focus on advanced therapeutic strategies such as catheter-based interventions, surgical approaches, and cardiopulmonary support. The impact of a multidisciplinary team approach to PE management is also discussed.

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Authors and Affiliations

  1. Department of Surgery, Division of Cardiac Surgery, University of Maryland, Baltimore, MD, USA

    R. J. Madathil & R. Cires-Drouet

  2. Department of Surgery, Division of Vascular Surgery, University of Maryland, Baltimore, MD, USA

    J. Anagnostakos, G. Pereira & M. Hall

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  1. R. J. Madathil
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  2. J. Anagnostakos
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  3. G. Pereira
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  4. M. Hall
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  5. R. Cires-Drouet
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Correspondence to R. Cires-Drouet.

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Ronson Madathil MD declares he has no conflict of interest. John Anagnostakos MD declares he has no conflict of interest. Gabriel Pereira MD declares he has no conflict of interest. Michael Hall MD declares he has no conflict of interest. Rafael S. Cires-Drouet MD declares he has no conflict of interest

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Madathil, R., Anagnostakos, J., Pereira, G. et al. Current Management of Acute Pulmonary Embolism. Curr Surg Rep 9, 16 (2021). https://doi.org/10.1007/s40137-021-00293-7

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