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Percutaneous interventions for pulmonary embolism.经皮介入治疗肺栓塞。
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2
Prospective Multicenter International Registry of Ultrasound-Facilitated Catheter-Directed Thrombolysis in Intermediate-High and High-Risk Pulmonary Embolism (KNOCOUT PE).超声引导下经导管溶栓治疗中高危和高危肺栓塞的前瞻性多中心国际登记研究(KNOCOUT PE)。
Circ Cardiovasc Interv. 2024 Mar;17(3):e013448. doi: 10.1161/CIRCINTERVENTIONS.123.013448. Epub 2024 Jan 24.
3
Outcomes in High-Risk Pulmonary Embolism Patients Undergoing FlowTriever Mechanical Thrombectomy or Other Contemporary Therapies: Results From the FLAME Study.血流导向装置机械血栓切除术或其他当代疗法治疗高危肺栓塞患者的结局:来自 FLAME 研究的结果。
Circ Cardiovasc Interv. 2023 Oct;16(10):e013406. doi: 10.1161/CIRCINTERVENTIONS.123.013406. Epub 2023 Oct 17.
4
Catheter-Directed Thrombolysis vs Anticoagulation in Patients With Acute Intermediate-High-risk Pulmonary Embolism: The CANARY Randomized Clinical Trial.急性中高危肺栓塞患者的导管直接溶栓与抗凝治疗:CANARY 随机临床试验。
JAMA Cardiol. 2022 Dec 1;7(12):1189-1197. doi: 10.1001/jamacardio.2022.3591.
5
Cost-of-Illness Analysis of Long-Term Health Care Resource Use and Disease Burden in Patients With Pulmonary Embolism: Insights From the PREFER in VTE Registry.肺栓塞患者长期医疗资源使用和疾病负担的成本效益分析:来自 PREFER 静脉血栓栓塞症登记研究的见解。
J Am Heart Assoc. 2022 Oct 18;11(20):e027514. doi: 10.1161/JAHA.122.027514. Epub 2022 Oct 17.
6
Percutaneous treatment options for acute pulmonary embolism: a clinical consensus statement by the ESC Working Group on Pulmonary Circulation and Right Ventricular Function and the European Association of Percutaneous Cardiovascular Interventions.经皮治疗急性肺栓塞的选择:ESC 肺循环和右心室功能工作组和欧洲经皮心血管介入协会的临床共识声明。
EuroIntervention. 2022 Oct 7;18(8):e623-e638. doi: 10.4244/EIJ-D-22-00246.
7
2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension.2022年欧洲心脏病学会/欧洲呼吸学会肺动脉高压诊断和治疗指南。
Eur Respir J. 2023 Jan 6;61(1). doi: 10.1183/13993003.00879-2022. Print 2023 Jan.
8
A pilot randomised trial of catheter-directed thrombolysis or standard anticoagulation for patients with intermediate-high risk acute pulmonary embolism.急性中高危肺栓塞患者导管溶栓与标准抗凝的随机对照初步研究。
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9
Percutaneous mechanical thrombectomy in a real-world pulmonary embolism population: Interim results of the FLASH registry.真实世界肺栓塞人群中经皮机械血栓切除术:FLASH 登记研究的中期结果。
Catheter Cardiovasc Interv. 2022 Mar;99(4):1345-1355. doi: 10.1002/ccd.30091. Epub 2022 Feb 3.
10
A seven-year single-center experience on AngioJet rheolytic thrombectomy in patients with pulmonary embolism at high risk and intermediate-high risk.一项为期七年的单中心研究:在高危和中高危肺栓塞患者中应用 AngioJet 旋切血栓清除术。
Anatol J Cardiol. 2021 Dec;25(12):902-911. doi: 10.5152/AnatolJCardiol.2021.28303.

肺栓塞和深静脉血栓形成的新挑战与治疗选择

Novel Challenges and Therapeutic Options for Pulmonary Embolism and Deep Vein Thrombosis.

作者信息

Cavallino Chiara, Franzino Marco, Abdirashid Mohamed, Maltese Ludovica, Bacci Elodi, Rametta Francesco, Ugo Fabrizio

机构信息

Cardiology Division, Sant'Andrea Hostpital, 13100 Vercelli, Italy.

出版信息

J Pers Med. 2024 Aug 21;14(8):885. doi: 10.3390/jpm14080885.

DOI:10.3390/jpm14080885
PMID:39202076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11355608/
Abstract

Acute pulmonary embolism (PE), often resulting from deep vein thrombosis (DVT), is the third most frequent cause of cardiovascular death and is associated with increasing incidence, causing considerable morbidity and mortality. This review aims to evaluate the efficacy, safety, and outcomes of treatment options in the management of acute PE and DVT, encompassing both established and emerging technologies, such as catheter-directed thrombolysis, aspiration thrombectomy, and other endovascular techniques. A comprehensive literature review was conducted, assessing clinical studies, trials, and case reports that detail the use of percutaneous interventions for PE and DVT and analyzing the advantages and disadvantages of each percutaneous system. Several percutaneous treatments have shown promising results, especially in cases where rapid thrombus resolution is critical, such as in high- and intermediate-high-risk patients. The incidence of major complications, such as bleeding, remains a consideration, though it is generally manageable with proper patient selection and technique. It is fundamentally important to tailor the specific treatment strategy to the clinical and anatomical characteristics of each patient. Percutaneous treatments for acute PE and DVT represent valuable options in the therapeutic arsenal, offering enhanced outcomes in appropriately selected patients. Ongoing advancements in technology and technique, along with comprehensive clinical trials, are essential to further define the role and optimize the use of these interventions.

摘要

急性肺栓塞(PE)通常由深静脉血栓形成(DVT)引起,是心血管死亡的第三大常见原因,且发病率不断上升,导致相当高的发病率和死亡率。本综述旨在评估急性PE和DVT治疗方案的疗效、安全性及预后,涵盖已成熟和新兴的技术,如导管定向溶栓、血栓抽吸清除术及其他血管内技术。进行了全面的文献综述,评估了详细介绍经皮干预治疗PE和DVT的临床研究、试验及病例报告,并分析了每种经皮系统的优缺点。几种经皮治疗已显示出有前景的结果,尤其是在快速溶解血栓至关重要的情况下,如在高危和中高危患者中。尽管通过适当的患者选择和技术,主要并发症(如出血)的发生率通常是可控的,但它仍是一个需要考虑的因素。根据每位患者的临床和解剖特征制定具体的治疗策略至关重要。急性PE和DVT的经皮治疗是治疗手段中的宝贵选择,可为适当选择的患者带来更好的预后。技术和技巧的不断进步以及全面的临床试验对于进一步明确这些干预措施的作用并优化其使用至关重要。