Department of Interventional Radiology, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
Department of Respiratory Medicine, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.
Br J Radiol. 2023 Sep;96(1149):20221151. doi: 10.1259/bjr.20221151. Epub 2023 Jul 14.
Venous thromboembolic disease presenting with acute pulmonary embolus (PE) can be treated in a variety of ways from anticoagulation as an outpatient to surgical embolectomy with many new interventional therapies being developed. Mortality in these patients can be as high as 50% and many of these treatments are also considered to be high risk. Early involvement of a multidisciplinary team and patient risk stratification can aid management decisions in these complex patients who can suddenly deteriorate.In this review, we summarise the evidence behind new and developing interventional therapies in the treatment of high and intermediate-high risk PE including catheter-directed thrombolysis, pharmacomechanical thrombolysis, thromboaspiration and the growing role of extracorporeal membrane oxygenation in the stabilisation and management of this cohort of patients.
静脉血栓栓塞疾病表现为急性肺栓塞 (PE)，可通过多种方式进行治疗，从门诊抗凝治疗到外科血栓切除术，同时还开发了许多新的介入治疗方法。这些患者的死亡率高达 50%，许多治疗方法也被认为是高风险的。多学科团队的早期介入和患者风险分层可以帮助管理这些复杂患者的决策，这些患者可能会突然恶化。在这篇综述中，我们总结了新的和正在发展的介入治疗方法在高危和中高危 PE 治疗中的证据，包括导管定向溶栓、药物机械溶栓、血栓抽吸以及体外膜氧合在这组患者的稳定和管理中的作用日益增强。
