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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.

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。

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本文引用的文献

1
Percutaneous interventions for pulmonary embolism.经皮介入治疗肺栓塞。
EuroIntervention. 2024 Apr 1;20(7):e408-e424. doi: 10.4244/EIJ-D-23-00895.

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