Pulmonary Embolism: Contemporary Medical Management and Future Perspectives
Pulmonary embolism (PE) contributes substantially to the global disease burden. A key determinant of early adverse outcomes is the presence (and severity) of right ventricular dysfunction. Consequently, risk-adapted management strategies continue to evolve, tailoring acute treatment to the patients’...
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| Published in | Annals of Vascular Diseases Vol. 11; no. 3; pp. 265 - 276 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The Editorial Committee of Annals of Vascular Diseases
25.09.2018
Japanese College of Angiology / The Japanese Society for Vascular Surgery / Japanese Society of Phlebology |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1881-641X 1881-6428 1881-6428 |
| DOI | 10.3400/avd.ra.18-00054 |
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| Abstract | Pulmonary embolism (PE) contributes substantially to the global disease burden. A key determinant of early adverse outcomes is the presence (and severity) of right ventricular dysfunction. Consequently, risk-adapted management strategies continue to evolve, tailoring acute treatment to the patients’ clinical presentation, hemodynamic status, imaging and biochemical markers, and comorbidity. For subjects with hemodynamic instability or ‘high-risk’ PE, immediate systemic reperfusion treatment with intravenous thrombolysis is indicated; emerging approaches such as catheter-directed pharmacomechanical reperfusion might help to minimize the bleeding risk. Currently, direct, non-vitamin K-dependent oral anticoagulants are the mainstay of treatment for acute PE. They have been shown to simplify initial and extended anticoagulation regimens while reducing the bleeding risk compared to vitamin K antagonists. (This is a review article based on the invited lecture of the 37th Annual Meeting of Japanese Society of Phlebology.) |
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| AbstractList | Pulmonary embolism (PE) contributes substantially to the global disease burden. A key determinant of early adverse outcomes is the presence (and severity) of right ventricular dysfunction. Consequently, risk-adapted management strategies continue to evolve, tailoring acute treatment to the patients’ clinical presentation, hemodynamic status, imaging and biochemical markers, and comorbidity. For subjects with hemodynamic instability or ‘high-risk’ PE, immediate systemic reperfusion treatment with intravenous thrombolysis is indicated; emerging approaches such as catheter-directed pharmacomechanical reperfusion might help to minimize the bleeding risk. Currently, direct, non-vitamin K-dependent oral anticoagulants are the mainstay of treatment for acute PE. They have been shown to simplify initial and extended anticoagulation regimens while reducing the bleeding risk compared to vitamin K antagonists. (This is a review article based on the invited lecture of the 37th Annual Meeting of Japanese Society of Phlebology.) Pulmonary embolism (PE) contributes substantially to the global disease burden. A key determinant of early adverse outcomes is the presence (and severity) of right ventricular dysfunction. Consequently, risk-adapted management strategies continue to evolve, tailoring acute treatment to the patients' clinical presentation, hemodynamic status, imaging and biochemical markers, and comorbidity. For subjects with hemodynamic instability or 'high-risk' PE, immediate systemic reperfusion treatment with intravenous thrombolysis is indicated; emerging approaches such as catheter-directed pharmacomechanical reperfusion might help to minimize the bleeding risk. Currently, direct, non-vitamin K-dependent oral anticoagulants are the mainstay of treatment for acute PE. They have been shown to simplify initial and extended anticoagulation regimens while reducing the bleeding risk compared to vitamin K antagonists. (This is a review article based on the invited lecture of the 37th Annual Meeting of Japanese Society of Phlebology.).Pulmonary embolism (PE) contributes substantially to the global disease burden. A key determinant of early adverse outcomes is the presence (and severity) of right ventricular dysfunction. Consequently, risk-adapted management strategies continue to evolve, tailoring acute treatment to the patients' clinical presentation, hemodynamic status, imaging and biochemical markers, and comorbidity. For subjects with hemodynamic instability or 'high-risk' PE, immediate systemic reperfusion treatment with intravenous thrombolysis is indicated; emerging approaches such as catheter-directed pharmacomechanical reperfusion might help to minimize the bleeding risk. Currently, direct, non-vitamin K-dependent oral anticoagulants are the mainstay of treatment for acute PE. They have been shown to simplify initial and extended anticoagulation regimens while reducing the bleeding risk compared to vitamin K antagonists. (This is a review article based on the invited lecture of the 37th Annual Meeting of Japanese Society of Phlebology.). |
| Author | Konstantinides, Stavros V. Barco, Stefano |
| Author_xml | – sequence: 1 fullname: Barco, Stefano organization: Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University – sequence: 1 fullname: Konstantinides, Stavros V. organization: Department of Cardiology, Democritus University of Thrace |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30402174$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_2478_sjecr_2020_0032 crossref_primary_10_1155_2020_7561986 crossref_primary_10_18332_pne_188202 |
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| Copyright | 2018 The Editorial Committee of Annals of Vascular Diseases. This article is distributed under the terms of the Creative Commons Attribution License, which permits use, distribution, and reproduction in any medium, provided the credit of the original work, a link to the license, and indication of any change are properly given, and the original work is not used for commercial purposes. Remixed or transformed contributions must be distributed under the same license as the original. Copyright © 2018 Annals of Vascular Diseases 2018 |
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| Keywords | thrombolysis direct oral anticoagulants right ventricular dysfunction risk stratification pulmonary embolism venous thromboembolism |
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