医学
经皮
肺栓塞
溶栓
心理干预
栓子切除术
重症监护医学
心脏病学
外科
心肌梗塞
精神科
作者
Simone Finocchiaro,Maria Sara Mauro,Carla Rochira,Marco Spagnolo,Claudio Laudani,Davide Landolina,Placido Maria Mazzone,Federica Agnello,Nicola Ammirabile,Denise Cristiana Faro,Antonino Imbesi,Giovanni Occhipinti,Antonio Greco,Davide Capodanno
出处
期刊:Eurointervention
[Europa Digital and Publishing]
日期:2024-04-01
卷期号:20 (7): e408-e424
被引量:2
标识
DOI:10.4244/eij-d-23-00895
摘要
Pulmonary embolism (PE) ranks as a leading cause of in-hospital mortality and the third most common cause of cardiovascular death. The spectrum of PE manifestations varies widely, making it difficult to determine the best treatment approach for specific patients. Conventional treatment options include anticoagulation, thrombolysis, or surgery, but emerging percutaneous interventional procedures are being investigated for their potential benefits in heterogeneous PE populations. These novel interventional techniques encompass catheter-directed thrombolysis, mechanical thrombectomy, and hybrid approaches combining different mechanisms. Furthermore, inferior vena cava filters are also available as an option for PE prevention. Such interventions may offer faster improvements in right ventricular function, as well as in pulmonary and systemic haemodynamics, in individual patients. Moreover, percutaneous treatment may be a valid alternative to traditional therapies in high bleeding risk patients and could potentially reduce the burden of mortality related to major bleeds, such as that of haemorrhagic strokes. Nevertheless, the safety and efficacy of these techniques compared to conservative therapies have not been conclusively established. This review offers a comprehensive evaluation of the current evidence for percutaneous interventions in PE and provides guidance for selecting appropriate patients and treatments. It serves as a valuable resource for future researchers and clinicians seeking to advance this field. Additionally, we explore future perspectives, proposing "percutaneous primary pulmonary intervention" as a potential paradigm shift in the field.
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