Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia.
Vanderbilt Heart and Vascular Institute, Nashville, Tennessee.
J Am Coll Cardiol. 2016 Mar 1;67(8):991-1002. doi: 10.1016/j.jacc.2015.12.024.
Compared with recent advances in treatment of serious cardiovascular diseases, such as myocardial infarction and stroke, the treatment and outcome of acute pulmonary embolism (PE) have remained relatively unchanged over the last few decades. This has prompted several experts to call for the formation of multidisciplinary PE response teams with a more proactive approach to the treatment of PE. In the current document, we discuss the formation of such teams and describe the available treatment options beyond anticoagulation, with a focus on the interventional approach. Acknowledging the paucity of data to support widespread adoption of such techniques, we call for the collection of outcomes data in multicenter registries and support for randomized trials to evaluate interventional treatments in patients with high-risk PE.
与心肌梗死和中风等严重心血管疾病治疗方面的最新进展相比,过去几十年中急性肺栓塞 (PE) 的治疗和结局变化相对较小。这促使一些专家呼吁组建多学科的 PE 反应团队,对 PE 的治疗采取更积极主动的方法。在本文件中,我们讨论了此类团队的组建,并描述了抗凝治疗以外的可用治疗选择,重点是介入方法。鉴于缺乏支持广泛采用此类技术的数据,我们呼吁在多中心登记处收集结局数据,并支持随机试验,以评估高危 PE 患者的介入治疗。