Submassive PE: Why and How to Intervene

• 作 者: SanjivParikh;
• 机 构: Interventional Radiology Swedish Medical Center-Cherry Hill Campus USA
• 出 处: 2011第三届心脏病学大会
• 发表日期: 2011年期

　　BACKGROUND: Patients with massive pulmonary embolism (PE), who present with signs of severe right ventricular dysfunction (RVD) and cardiogenic shock, are routinely treated using aggressive strategies.Whether similar treatments should be performed in submassive PE patients, who also present with signs of RVD albeit being hemodynamically stable, remains a topic of debate.The current review examines the clinical evidence in support of treating submassive PE patients aggressively and highlights a novel strategy that has demonstrated success.MATERIALS AND METHODS: We conducted a literature review of recent studies where long-term outcomes were reported for acute PE patients with various degrees of RVD, characteristic of submassive PE.We also reviewed our institutional experience using aggressive treatments for acute submassive PE patients.CONCLUSION: Based on the clinical evidence reviewed, submassive PE is associated with poor prognosis when treated conservatively; Multicenter Experience demonstrates that catheter-directed thrombolysis (CDT) can be safely administered to patients with acute PE and Ultrasonic CDT holds promise of becoming the first-line treatment for both acute submassive and massive PE.