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Advanced Management of Intermediate- and High-Risk Pulmonary Embolism: JACC Focus Seminar.

Abstract：

:Intermediate-risk (submassive) pulmonary embolism (PE) describes normotensive patients with evidence of right ventricular compromise, whereas high-risk (massive) PE comprises those who have experienced hemodynamic decompensation with hypotension, cardiogenic shock, or cardiac arrest. Together, these 2 syndromes represent the most clinically challenging manifestations of the PE spectrum. Prompt therapeutic anticoagulation remains the cornerstone of therapy for both intermediate- and high-risk PE. Patients with intermediate-risk PE who subsequently deteriorate despite anticoagulation and those with high-risk PE require additional advanced therapies, typically focused on pulmonary artery reperfusion. Strategies for reperfusion therapy include systemic fibrinolysis, surgical pulmonary embolectomy, and a growing number of options for catheter-based therapy. Multidisciplinary PE response teams can aid in selection of appropriate management strategies, especially where gaps in evidence exist and guideline recommendations are sparse.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Piazza G

doi

10.1016/j.jacc.2020.05.028

subject

Has Abstract

pub_date

2020-11-03 00:00:00

pages

2117-2127

issue

18

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(20)35322-5

journal_volume

76

pub_type

杂志文章,评审

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