Document Detail

Massive pulmonary embolism: review of management strategies with a focus on catheter-based techniques.
MedLine Citation:
PMID:  20528643     Owner:  NLM     Status:  MEDLINE    
Massive or high-risk pulmonary embolism (PE), defined as PE in the setting of (transient) arterial hypotension or frank cardiogenic shock, is associated with a poor prognosis. Fibrinolytic therapy is the mainstay of therapy, although data to support its effectiveness are limited. Although rarely performed, an alternate, accepted treatment strategy is surgical embolectomy. Contraindications to fibrinolytics are common in the setting of high-risk PE, and surgical embolectomy is frequently not performed owing to excessively high surgical risk. Under those circumstances, percutaneous, catheter-based thrombectomy or thrombus fragmentation is a reasonable alternative. In this article, we summarize the data available to date, evaluating the three different treatment options. We also attempt to synthesize a treatment algorithm to guide the practitioner in the treatment of patients with high-risk or massive PE.
Licheng Lee; Clifford J Kavinsky; Christian Spies
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  8     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-09     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  863-73     Citation Subset:  IM    
The University of Hawaii, Department of Medicine, Honolulu, HI, USA.
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MeSH Terms
Catheterization / adverse effects,  contraindications
Embolectomy / adverse effects,  contraindications
Fibrinolytic Agents / adverse effects,  contraindications,  therapeutic use
Hypotension / physiopathology
Practice Guidelines as Topic
Pulmonary Artery / pathology,  surgery
Pulmonary Embolism / diagnosis,  drug therapy*,  physiopathology,  therapy*
Severity of Illness Index
Shock, Cardiogenic / physiopathology
Thrombectomy / adverse effects,  contraindications
Thrombolytic Therapy / adverse effects,  contraindications
Reg. No./Substance:
0/Fibrinolytic Agents

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