Department of Cardiology, Lenox Hill Hospital, New York, NY.
Department of Cardiology, Westchester Medical Center, Valhalla, NY.
J Card Fail. 2024 Oct;30(10):1319-1329. doi: 10.1016/j.cardfail.2024.07.012.
Acute pulmonary embolism (PE) represents the third leading cause of cardiovascular mortality, with most PE-related mortality associated with acute right ventricular (RV) failure. Despite an increase in attention to acute PE with new endovascular devices for therapy and the adoption of multidisciplinary clinical treatment teams, mortality rates remain high in patients who present with PE-related hemodynamic compromise. Currently, the advanced treatment modalities for acute high-risk and intermediate high-risk PE are limited to several interventional modalities-open surgical embolectomy and systemic fibrinolytic agents. The purpose of this state-of-the-art review is to describe modern therapeutic techniques and strategies (both interventional and surgical) and the role of mechanical circulatory support (MCS) for hemodynamic compromise in PE.
急性肺栓塞(PE)是心血管疾病死亡的第三大原因,大多数与 PE 相关的死亡与急性右心室(RV)衰竭有关。尽管新的血管内治疗设备和多学科临床治疗团队的采用增加了对急性 PE 的关注,但出现 PE 相关血流动力学障碍的患者死亡率仍然很高。目前,急性高危和中高危 PE 的高级治疗方法仅限于几种介入方法——开放性外科取栓术和全身纤维蛋白溶解剂。本综述的目的是描述现代治疗技术和策略(介入和手术)以及机械循环支持(MCS)在 PE 中血流动力学障碍中的作用。