Clot busters for pulmonary embolism12/28/2023 ![]() ![]() This review will outline the different clinical presentation of PE, and will summarize the available endovascular treatments and the different techniques with its indications and outcomes. Since there are a variety of CDT and thrombectomy methods, more prospective studies are still needed to refine the interventional approach protocol and determine the safest techniques in larger cohorts. According to the clinical guidelines of the American College of Chest Physicians (ACCP) an interventional approach, in an acute massive PE, currently is only considered the treatment of choice when a systemic thrombolysis therapy fails or is contraindicated however other authors advocate the use of the following procedures: Catheter directed therapy (CDT), mechanical fragmentation, thrombectomy procedures as a more aggressive therapeutic management that can provide excellent results in a massive PE. ![]() Other authors also advocate to implant an inferior vena cava filter (IVCf) in massive PE to prevent further thrombus migration and avoid higher thrombotic load or avoid anticoagulation therapy. For a massive PE there are three different treatments options: (1) systemic thrombolysis (2) Surgical pulmonary embolectomy and (3) Endovascular techniques. Acute PE is also the leading cause of pulmonary hypertension and right ventricular failure.įrom the clinical point of view, two different situations need to be considered, prognosis and therapeutic management. In the first three months after an acute PE, there is an estimated of 15% mortality among submassive PE, and 68% mortality in massive PE. VTE is the third leading cause of death after myocardial infarction and stroke. The incidence rate of VTE is 100 cases per 100000 inhabitants in Europe and 100 inhabitants in the United States. Venous thromboembolism (VTE) is a life-threatening condition that affects a large percentage of the global population VTE includes the deep vein thrombosis (DVT) and pulmonary embolism (PE).
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