| Massive pulmonary embolism: review of management strategies with a focus on catheter-based techniques. | |
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MedLine Citation:
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PMID: 20528643 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Licheng Lee; Clifford J Kavinsky; Christian Spies |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Expert review of cardiovascular therapy Volume: 8 ISSN: 1744-8344 ISO Abbreviation: Expert Rev Cardiovasc Ther Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-06-09 Completed Date: 2010-10-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101182328 Medline TA: Expert Rev Cardiovasc Ther Country: England |
Other Details:
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Languages: eng Pagination: 863-73 Citation Subset: IM |
Affiliation:
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The University of Hawaii, Department of Medicine, Honolulu, HI, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms Catheterization / adverse effects, contraindications Embolectomy / adverse effects, contraindications Fibrinolytic Agents / adverse effects, contraindications, therapeutic use Humans Hypotension / physiopathology Practice Guidelines as Topic Prognosis 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 |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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