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Pulmonary Embolism: Clinical Advances and Future Opportunities
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Pulmonary Embolism: Clinical Advances and Future Opportunities

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 25 December 2025 | Viewed by 2318

Special Issue Editor

Dr. James Horowitz

E-Mail Website
Guest Editor
Department of Medicine, Division of Cardiology, New York University Grossman School of Medicine, New York, NY, USA
Interests: pulmonary embolism; critical care cardiology; cardiac arrest; cardiogenic shock; mechanical circulatory support; cardiogenic shock teams

Special Issue Information

Dear Colleagues,

Pulmonary embolism(PE) is the third leading cause of cardiovascular death and a major contributor to long-term morbidity. With the evolution of catheter-based therapies, we have seen significant evolution in pulmonary embolism care over the recent years. Several recent published registries offer insight into these advances while randomized controled trials underway will inform our future practice.

In this special issue of the Journal of Clinical Medicine, “Pulmonary Embolism: Clinical Advances and Future Opportunities” we aim to highlight recent developments in the field of advanced pulmonary embolism care and future directions in the field. We hope to review developments with respect to interventional therapies, risk assessment, Pulmonary Embolism Response Teams, and pharmacologic and mechanical circulatory support for the failing right ventricle. We cordially invite cotributions from worldwide experts in the field of pulmonary embolism care exploring the aforementioned issues in this special issue.

Dr. James Horowitz
Guest Editor

Manuscript Submission Information

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Keywords

  • pulmonary embolism
  • risk stratification
  • pulmonary embolism response teams
  • high risk PE
  • massive PE
  • intermediate risk PE
  • sub massive PE
  • catheter directed thrombolysis
  • catheter thrombectomy
  • catheter directed embolectomy
  • extra corporeal membrane oxygenation

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Published Papers (3 papers)

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Research

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12 pages, 1528 KB  
Article
Echo-Doppler Predictors of Residual Pulmonary Hypertension After Pulmonary Thromboendarterectomy
by Estefania Oliveros, Anil Jonnalagadda, Rylie Pietrowicz, Madeline Mauri, Huaqing Zhao, Rohit Maruthi, Hollie Saunders, Vladimir Lakhter, Yevgeniy Brailovsky, Riyaz Bashir, Ahmed Sadek, Anjali Vaidya and Paul Forfia
J. Clin. Med. 2025, 14(16), 5705; https://doi.org/10.3390/jcm14165705 - 12 Aug 2025
Viewed by 509
Abstract
Background: Pulmonary thromboendarterectomy (PTE) remains the preferred treatment for surgical accessible thrombus in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, residual pulmonary hypertension (PH) can persist post-PTE. Methods: A retrospective single-center analysis of patients that underwent PTE between 2013 and 2023. At [...] Read more.
Background: Pulmonary thromboendarterectomy (PTE) remains the preferred treatment for surgical accessible thrombus in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, residual pulmonary hypertension (PH) can persist post-PTE. Methods: A retrospective single-center analysis of patients that underwent PTE between 2013 and 2023. At 3-month follow-up, we performed a qualitative Echo-Doppler (DE) assessment and applied a semi-quantitative DE scoring system (DESS), assigning point values for six DE parameters: right ventricle (RV) size, RV shape (systolic base–apex ratio), RV function, septal position, tricuspid regurgitation (TR) and RV outflow tract notching (RVOTN). Higher scores suggested a more significant residual PH syndrome. Results: A total of 188 subjects (80%) did not require further PH intervention at ≥3 months (Group A); 48 (20%) required ongoing PH treatment (Group B). The pre-PTE median DESS was 10 and the post-PTE median DESS was 3.00 (range 0–16). The maximum DESS was 17. Using ROC analysis, post-PTE DESS strongly discriminated between Group A and B (AUC 0.76; 95% CI 0.65–0.89; p < 0.001). A post-PTE DESS of >6.5 differentiated Group A and B. Evidence of TR (OR 0.191, CI 0.103–0.279; p < 0.0001) and RV enlargement (OR 0.242; CI 0.153–0.330; p < 0.0001) at follow-up was associated with a need for additional PH interventions. Conclusions: Serial DE examination is a viable, noninvasive method to assess significant residual PH post-PTE. Full article
(This article belongs to the Special Issue Pulmonary Embolism: Clinical Advances and Future Opportunities)
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14 pages, 487 KB  
Article
Sex-Based Differences in Clinical Presentation, Management, and Outcomes in Patients Hospitalized with Pulmonary Embolism: A Retrospective Cohort Study
by Benjamin Troxler, Maria Boesing, Cedrine Kueng, Fabienne Jaun, Joerg Daniel Leuppi and Giorgia Lüthi-Corridori
J. Clin. Med. 2025, 14(15), 5287; https://doi.org/10.3390/jcm14155287 - 26 Jul 2025
Viewed by 494
Abstract
Background/Objectives: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain [...] Read more.
Background/Objectives: Pulmonary embolism (PE) remains a major cause of morbidity and mortality. Despite advances in care, its nonspecific symptoms pose diagnostic and therapeutic challenges. Emerging evidence suggests sex-based differences in PE presentation, management, and outcomes, yet real-world data from European settings remain scarce. This study aimed to investigate sex differences in clinical presentation, diagnostic workup, therapeutic interventions, and outcomes among hospitalized PE patients. Methods: We conducted a retrospective cohort study including all adult patients (≥18 years) admitted with a main diagnosis of acute PE at the Cantonal Hospital Baselland between January 2018 and December 2020. Data were extracted from electronic medical records and included demographics, comorbidities, symptoms, diagnostics, treatments, and outcomes. Sex-based comparisons were performed using univariate analyses. Results: Among 197 patients, 54% were women. Compared to men, women were more often admitted by ambulance (42% n = 45 vs. 24% n = 22, p = 0.009), had more frequent tachycardia (38% n = 41 vs. 23% n = 21, p = 0.024), and received lysis therapy more often (10% n = 11 vs. 2% n = 2, p = 0.023). DVT was more frequently diagnosed in women when sonography was performed (82% n = 49 vs. 64% n = 34, p = 0.035). Men had higher rates of B symptoms, smoking, and family history of PE. Women had longer hospital stays and were more frequently discharged to rehabilitation facilities. No sex differences were found in in-hospital mortality, 6-month rehospitalization, or adherence to diagnostic guidelines. Conclusions: This study reveals sex-based differences in PE presentation and management, suggesting potential disparities in care pathways. Further research is needed to promote equitable, personalized treatment strategies. Full article
(This article belongs to the Special Issue Pulmonary Embolism: Clinical Advances and Future Opportunities)
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Review

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14 pages, 398 KB  
Review
IVC Filters in Integrated Acute Pulmonary Embolism Management—A Narrative Review
by Joseph P. Hart and Mark G. Davies
J. Clin. Med. 2025, 14(19), 6810; https://doi.org/10.3390/jcm14196810 - 26 Sep 2025
Viewed by 789
Abstract
Acute pulmonary embolism (APE) remains a significant cause of mortality and morbidity despite increasing prophylaxis for deep venous thrombosis (DVT). The IVC filter is a temporary or permanent intravascular device that traps migrating thrombi from their origin in the pelvis or a lower [...] Read more.
Acute pulmonary embolism (APE) remains a significant cause of mortality and morbidity despite increasing prophylaxis for deep venous thrombosis (DVT). The IVC filter is a temporary or permanent intravascular device that traps migrating thrombi from their origin in the pelvis or a lower limb into the pulmonary vasculature, thereby preventing significant APE. The current and longstanding indications for placing an IVC filter are in patients with documented lower extremity DVT and acute APE who also have absolute contraindications to anticoagulation or have experienced an acute, hemodynamically unstable APE requiring ventilatory and vasoactive support, with limited cardiovascular reserve. Updated guidelines have led to a significant rise in IVC filter placements for specific therapeutic indications of venous thromboembolism compared to prophylactic use. Meta-analyses show that IVC filter placement is associated with a lower risk of subsequent APE but an increased risk of DVT. However, there appears to be no significant reduction in APE-related mortality and no change in all-cause mortality. Early complications after IVC filter placement typically relate to procedural issues and include bleeding or infection at the venous access site, development of arteriovenous fistulas, accidental arterial puncture, and post-procedural access site hematoma or thrombosis. Additional early complications include IVC filter malposition, incomplete expansion, IVC penetration, or guidewire entrapment. Delayed complications may involve DVT below the filter, IVC occlusion due to the filter, IVC filter migration, fracture of one of the IVC filter components, IVC rupture, or IVC thrombosis. Retrieval of IVC filters by simple, advanced, or open techniques should be considered after weighing the risk-to-benefit for the individual patient. Deployment of the IVC filter remains an important component of interventional APE management within the narrow indications currently proposed. Current guidance recommends that an untethered temporary IVC filter should be placed and retrieved once the contraindication to anticoagulation is resolved. Full article
(This article belongs to the Special Issue Pulmonary Embolism: Clinical Advances and Future Opportunities)
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