Yuriditsky Eugene, Zhang Robert S, Ahuja Tania, Bangalore Sripal, Horowitz James M
Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
Division of Cardiology, Weill Cornell Medicine, New York, NY, USA.
Breathe (Sheff). 2025 Jun 17;21(2):240100. doi: 10.1183/20734735.0100-2024. eCollection 2025 Apr.
Therapeutic anticoagulation is the mainstay therapy in acute pulmonary embolism (PE), however, select patients benefit from emergent reperfusion to prevent or rescue acute right ventricular failure and haemodynamic collapse. Compared to other leading causes of cardiovascular mortality such as myocardial infarction and stroke, there is a substantial paucity of literature informing on advanced therapies in PE. Recent years have seen significant evolution in the armamentarium available for PE care with the uptake of several endovascular treatment modalities and increased use of mechanical circulatory support. While several ongoing randomised controlled trials may alter the therapeutic landscape and approach to PE management, at present, we are left with multiple selections with limited guidance. In this review, we discuss the latest therapeutic options available for acute PE and offer an approach to their implementation.
治疗性抗凝是急性肺栓塞(PE)的主要治疗方法,然而,部分患者可从紧急再灌注治疗中获益,以预防或挽救急性右心室衰竭和血流动力学崩溃。与心肌梗死和中风等其他主要心血管死亡原因相比,关于PE高级治疗的文献非常匮乏。近年来,随着多种血管内治疗方式的采用和机械循环支持的更多使用,用于PE治疗的手段有了显著发展。虽然一些正在进行的随机对照试验可能会改变PE治疗的格局和方法,但目前,我们面临多种选择却指导有限。在本综述中,我们讨论了急性PE的最新治疗选择,并提供了实施这些选择的方法。