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Review

Advanced Management of Patients Undergoing Transcatheter Treatment for Pulmonary Embolism: Evidence-Based Strategies for Optimized Patient Care

by
Francesco Costa
1,2,
Alfonso Jurado-Román
3,
Gabriele Carciotto
2,
Victor Becerra-Munoz
1,
Daniel Tébar Márquez
3,
Felix Götzinger
4,
Enrico Cerrato
5,
Shantum Misra
6,7,
Marco Spissu
5,
Marco Pavani
5,
Marco Mennuni
8,
Fernando Carrasco Chinchilla
1,
Antonio Dominguez-Franco
1,
Antonio Muñoz-Garcia
1,
Rocio Sanchez Navarrete
1,
Ferdinando Varbella
5,
Pablo Salinas-Sanguino
9,
Eric A. Secemsky
6,7,
Felix Mahfoud
4,
Antonio Micari
2,
Juan Horacio Alonso-Briales
1 and
Manuel Jimenez Navarro
1,*
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1
Área del Corazón, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (IBIMA Plataforma BIONAND), Hospital Universitario Virgen de la Victoria, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Departamento de Medicina UMA, 29010 Malaga, Spain
2
Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, 98122 Messina, Italy
3
Cardiology Department, University Hospital La Paz, 28046 Madrid, Spain
4
Department of Internal Medicine III—Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital Homburg, Saarland University, 66123 Saarbrücken, Germany
5
Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, 10098 Turin, Italy
6
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
7
Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Boston, MA 02215, USA
8
Division of Cardiology, Maggiore della Carità Hospital, 28100 Novara, Italy
9
Servicio de Cardiología, Hospital Clínico San Carlos, 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(24), 7780; https://doi.org/10.3390/jcm13247780
Submission received: 4 November 2024 / Revised: 9 December 2024 / Accepted: 14 December 2024 / Published: 20 December 2024
(This article belongs to the Special Issue Pulmonary Embolism: The Era of Catheter-Directed Treatment)

Abstract

Pulmonary embolism (PE) is a life-threatening medical condition caused by the thrombotic occlusion of one or more branches of the lung vasculature, which represents the third most common cause of cardiovascular mortality after myocardial infarction and stroke. PE treatment requires a tailored approach based on accurate risk stratification and personalized treatment decision-making. Anticoagulation is the cornerstone of PE management, yet patients at higher clinical risk may require more rapid reperfusion therapies. In recent years, transcatheter treatment has emerged as a valuable option for patients with intermediate–high or high-risk PE who have contraindications to systemic thrombolysis. Recent advancements in catheter-directed therapies, such as catheter-directed thrombolysis (CDT) and catheter-directed mechanical thrombectomy (CDMT), provide minimally invasive options for swift symptom relief and hemodynamic stabilization. This review aims to provide a practical approach for optimal patient selection and management for PE percutaneous therapies, supported by a thorough evaluation of the current evidence base supporting these procedures. A focus on post-procedural management, the prevention of recurrence, and monitoring for long-term complications such as chronic pulmonary hypertension and post-PE syndrome is also specifically tackled.
Keywords: pulmonary embolism; catheter-directed thrombolysis; catheter-directed mechanical thrombectomy; pulmonary hypertension pulmonary embolism; catheter-directed thrombolysis; catheter-directed mechanical thrombectomy; pulmonary hypertension

Share and Cite

MDPI and ACS Style

Costa, F.; Jurado-Román, A.; Carciotto, G.; Becerra-Munoz, V.; Márquez, D.T.; Götzinger, F.; Cerrato, E.; Misra, S.; Spissu, M.; Pavani, M.; et al. Advanced Management of Patients Undergoing Transcatheter Treatment for Pulmonary Embolism: Evidence-Based Strategies for Optimized Patient Care. J. Clin. Med. 2024, 13, 7780. https://doi.org/10.3390/jcm13247780

AMA Style

Costa F, Jurado-Román A, Carciotto G, Becerra-Munoz V, Márquez DT, Götzinger F, Cerrato E, Misra S, Spissu M, Pavani M, et al. Advanced Management of Patients Undergoing Transcatheter Treatment for Pulmonary Embolism: Evidence-Based Strategies for Optimized Patient Care. Journal of Clinical Medicine. 2024; 13(24):7780. https://doi.org/10.3390/jcm13247780

Chicago/Turabian Style

Costa, Francesco, Alfonso Jurado-Román, Gabriele Carciotto, Victor Becerra-Munoz, Daniel Tébar Márquez, Felix Götzinger, Enrico Cerrato, Shantum Misra, Marco Spissu, Marco Pavani, and et al. 2024. "Advanced Management of Patients Undergoing Transcatheter Treatment for Pulmonary Embolism: Evidence-Based Strategies for Optimized Patient Care" Journal of Clinical Medicine 13, no. 24: 7780. https://doi.org/10.3390/jcm13247780

APA Style

Costa, F., Jurado-Román, A., Carciotto, G., Becerra-Munoz, V., Márquez, D. T., Götzinger, F., Cerrato, E., Misra, S., Spissu, M., Pavani, M., Mennuni, M., Chinchilla, F. C., Dominguez-Franco, A., Muñoz-Garcia, A., Navarrete, R. S., Varbella, F., Salinas-Sanguino, P., Secemsky, E. A., Mahfoud, F., ... Navarro, M. J. (2024). Advanced Management of Patients Undergoing Transcatheter Treatment for Pulmonary Embolism: Evidence-Based Strategies for Optimized Patient Care. Journal of Clinical Medicine, 13(24), 7780. https://doi.org/10.3390/jcm13247780

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