Serhal Maya, Haddadin Ihab S, Heresi Gustavo A, Hornacek Deborah A, Shishehbor Mehdi H, Bartholomew John R
Vascular Medicine Section, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
Diagnostic Radiology, Cleveland Clinic Foundation, Cleveland, OH, USA.
J Thromb Thrombolysis. 2017 Jul;44(1):19-29. doi: 10.1007/s11239-017-1498-9.
Pulmonary embolism (PE) is a common thrombotic event that is variable in its presentation. Depending on the patients' risk for mortality, guidelines provide several treatment strategies including thrombolysis, catheter-directed therapies, pulmonary embolectomy, anticoagulation, and inferior vena cava filters. However, there is considerable disagreement between guidelines regarding the optimal treatment strategy for patients, particularly for those with intermediate-risk PE. In order to provide rapid and individualized care, PE response teams (PERT) have been developed. These teams consist of members from different specialties with a particular interest in PE, varying technical skills, and clinical experience, thereby allowing for a multidisciplinary approach. PERT allows for consensus decision making, and for rapid intervention in patients whose conditions worsen. In this review, we provide an overview of treatment guidelines for PE, and of results from recent clinical trials involving patients with submassive PE. In addition, we discuss an outline of our approach and use of PERT.
肺栓塞（PE）是一种常见的血栓形成事件，其临床表现多样。根据患者的死亡风险，指南提供了多种治疗策略，包括溶栓、导管定向治疗、肺动脉血栓切除术、抗凝治疗以及下腔静脉滤器置入。然而，不同指南对于患者的最佳治疗策略，尤其是中度风险肺栓塞患者的治疗策略，存在很大分歧。为了提供快速且个性化的治疗，肺栓塞反应团队（PERT）应运而生。这些团队由来自不同专业的成员组成，他们对肺栓塞有着特别的兴趣，具备不同的技术技能和临床经验，从而能够采用多学科方法。PERT有助于达成共识决策，并能对病情恶化的患者进行快速干预。在本综述中，我们概述了肺栓塞的治疗指南以及近期涉及亚大面积肺栓塞患者的临床试验结果。此外，我们还讨论了我们采用PERT的方法和使用情况概述。
