Perkan Andrea, Lo Giudice Francesco, Santangelo Sara, Magnani Silvia, Pyxaras Stylianos, Sinagra Gianfranco
Dipartmento Cardiovascolare e Scuola di Specializzazione in Malattie de'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria, Trieste.
G Ital Cardiol (Rome). 2011 Sep;12(9):577-87. doi: 10.1714/926.10171.
At present, high-risk pulmonary embolism represents a cardiovascular emergency burdened with high in-hospital mortality and characterized by acute right ventricular dysfunction and hemodynamic impairment. In addition to circulatory support and anticoagulation, thrombolytic therapy has become the cornerstone of the treatment in patients presenting with this condition. Despite the recommendations, a consistent proportion of patients does not currently receive thrombolytic therapy. Although performed in a limited number of patients, transcatheter and surgical embolectomy procedures are an alternative or synergistic therapeutic strategy to thrombolysis, enabling a prompt resolution of right ventricular volume overload. In this review, data from the literature are discussed with the aim of defining an algorithm for the treatment of high-risk patients.
目前，高危肺栓塞是一种心血管急症，具有较高的院内死亡率，其特征为急性右心室功能障碍和血流动力学损害。除循环支持和抗凝治疗外，溶栓治疗已成为患有这种疾病患者治疗的基石。尽管有相关推荐，但目前仍有一定比例的患者未接受溶栓治疗。虽然经导管和外科血栓切除术仅在少数患者中实施，但它们是溶栓治疗的替代或协同治疗策略，能够迅速缓解右心室容量超负荷。在这篇综述中，我们讨论了来自文献的数据，目的是确定一种针对高危患者的治疗方案。
