Why the study?
Acute PE carries mortality as high as 50% with high-risk treatments, prompting the need to summarize evidence behind new interventional therapies for high and intermediate-high risk patients.
This review highlights the emerging role of various interventional therapies and ECMO in managing complex, high-risk patients with acute pulmonary embolism.
May support interventional therapies and ECMO in high-risk PE; leaves open need for randomized trials before practice change.
Venous thromboembolic disease presenting with acute pulmonary embolus (PE) can be treated in a variety of ways from anticoagulation as an outpatient to surgical embolectomy with many new interventional therapies being developed. Mortality in these patients can be as high as 50% and many of these treatments are also considered to be high risk. Early involvement of a multidisciplinary team and patient risk stratification can aid management decisions in these complex patients who can suddenly deteriorate.In this review, we summarise the evidence behind new and developing interventional therapies in the treatment of high and intermediate-high risk PE including catheter-directed thrombolysis, pharmacomechanical thrombolysis, thromboaspiration and the growing role of extracorporeal membrane oxygenation in the stabilisation and management of this cohort of patients.
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Patel et al. (2023) studied this question.
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