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Advances in Treatment of Pulmonary Embolism

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

Deadline for manuscript submissions: closed (20 March 2025) | Viewed by 7152

Special Issue Editors


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Guest Editor
Departments of Medicine, Division of Cardiology, New York City Health + Hospitals/Jacobi Medical Center and the Albert Einstein College of Medicine, Bronx, NY, USA
Interests: pulmonary embolism; interventional cardiology; endovascular interventions; vascular medicine

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Guest Editor
Divisions of Cardiology and Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA
Interests: peripheral vascular disease; interventional cardiology; endovascular treatment; vascular medicine

Special Issue Information

Dear Colleagues,

Acute pulmonary embolism remains a leading cause of cardiovascular death and morbidity worldwide. Despite the advances in diagnosis and treatment of acute pulmonary embolism that have been made over recent years, many gaps remain in the literature regarding evidence-based approaches to the treatment of pulmonary embolism. As a result, treatment guidelines rely heavily on expert opinion.

This Special Issue on “Advances in Treatment of Pulmonary Embolism” in collaboration with The PERT ConsortiumTM seeks to update the current state of knowledge regarding diagnosis, risk stratification, multidisciplinary approaches utilizing pulmonary embolism response teams (PERT), medical and interventional treatments, and the appropriate follow-up of patients with pulmonary embolism.

We are seeking original research, review articles, and expert opinion pieces for this Special Issue. Suggested topics include: diagnosis of acute pulmonary embolism, imaging in pulmonary embolism, assessing the risk of patients with acute pulmonary embolism, pulmonary embolism response teams (PERT), percutaneous thrombectomy, catheter-directed thrombolysis, surgical thrombectomy, systemic thrombolysis, the role of mechanical circulatory support in the treatment of acute pulmonary embolism, and acute and long term anticoagulation in patients with pulmonary embolism.

Dr. Seth I. Sokol
Dr. Thomas M. Todoran
Guest Editors

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Keywords

  • acute pulmonary embolism
  • diagnosis
  • risk stratification
  • medical treatment
  • anticoagulation
  • interventional treatments
  • advanced therapies
  • PERT

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Published Papers (3 papers)

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Research

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9 pages, 544 KiB  
Article
Inflammatory and Metabolic Predictors of Mortality in Pulmonary Thromboembolism: A Focus on the Triglyceride–Glucose Index and Pan-Immune Inflammation Value
by Murat Bilgin, Emre Akkaya and Recep Dokuyucu
J. Clin. Med. 2024, 13(19), 6008; https://doi.org/10.3390/jcm13196008 - 9 Oct 2024
Cited by 5 | Viewed by 1230
Abstract
Objectives: We aimed to evaluate the importance of metabolic and inflammatory markers, specifically the Triglyceride–Glucose Index (TGI) and pan-immune inflammation value (PIV), in predicting mortality among patients diagnosed with pulmonary thromboembolism (PTE). Materials and Methods: A total of 450 patients diagnosed [...] Read more.
Objectives: We aimed to evaluate the importance of metabolic and inflammatory markers, specifically the Triglyceride–Glucose Index (TGI) and pan-immune inflammation value (PIV), in predicting mortality among patients diagnosed with pulmonary thromboembolism (PTE). Materials and Methods: A total of 450 patients diagnosed with PTE between December 2018 and December 2023 were included in his study. The diagnosis of PTE was confirmed by clinical presentation, laboratory tests, and imaging studies such as computed tomography pulmonary angiography (CTPA). Data were obtained from medical records, including demographic information, medical history, laboratory results, and clinical outcomes. Results: In terms of age, non-survivors were older on average (66.1 ± 11.8 years) compared to survivors (58.3 ± 12.4 years) (p = 0.03). In terms of gender, 55% of non-survivors and 45% of survivors were male (p = 0.111). Non-survivors had higher BMIs (28.3 ± 5.1) than survivors (25.7 ± 4.5) (p = 0.04). In terms of hypertension, 40% of non-survivors and 30% of survivors had hypertension (p = 0.041). In terms of diabetes, 35% of those who did not survive and 20% of those who survived had diabetes (p = 0.001). In terms of smoking, 25% of non-survivors and 15% of survivors smoke (p = 0.022). In terms of TGI, non-survivors had higher TGI values (12.1 ± 1.5) than survivors (5.9 ± 1.2) (p < 0.001). In terms of PIV, non-survivors had significantly higher PIV (878.2 ± 85.4) than survivors (254.5 ± 61.1) (p < 0.001). The risk factors found to be significantly associated with differentiation in the multiple logistic regression analysis included age, BMI, TGI, and PIV (p = 0.005, p = 0.002, p = 0.013, and 0.022, respectively). As a result, according to ROC analysis for patients who are non-survivors, age, BMI, TGI, and PIV were significant prognostic factors. The cut-off points for these values were >60, >27, >10, and >500, respectively. Conclusions: the TGI and PIV are strong markers for predicting mortality in PTE patients. The independent predictive value of age and BMI further demonstrates their role in risk stratification. We think that high TGI values and PIVs reflect underlying metabolic and inflammatory disorders that may contribute to worse outcomes in these patients. Full article
(This article belongs to the Special Issue Advances in Treatment of Pulmonary Embolism)
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12 pages, 1085 KiB  
Article
Comparison of In-Hospital Outcomes between Early and Late Catheter-Directed Thrombolysis in Acute Pulmonary Embolism: A Retrospective Observational Study
by Majd Al Deen Alhuarrat, Kirolos Barssoum, Medhat Chowdhury, Sheetal Vasundara Mathai, Miriam Helft, Michael Grushko, Prabhjot Singh, Hani Jneid, Afaq Motiwala, Robert T. Faillace and Seth I. Sokol
J. Clin. Med. 2024, 13(4), 1093; https://doi.org/10.3390/jcm13041093 - 15 Feb 2024
Cited by 1 | Viewed by 1518 | Correction
Abstract
The purpose of this study is to evaluate whether early initiation of catheter-directed thrombolysis (CDT) in patients presenting with acute pulmonary embolism is associated with improved in-hospital outcomes. A retrospective cohort was extracted from the 2016–2019 National Inpatient Sample database, consisting of 21,730 [...] Read more.
The purpose of this study is to evaluate whether early initiation of catheter-directed thrombolysis (CDT) in patients presenting with acute pulmonary embolism is associated with improved in-hospital outcomes. A retrospective cohort was extracted from the 2016–2019 National Inpatient Sample database, consisting of 21,730 weighted admissions undergoing CDT acute PE. From the time of admission, the sample was divided into early (<48 h) and late interventions (>48 h). Outcomes were measured using regression analysis and propensity score matching. No significant differences in mortality, cardiac arrest, cardiogenic shock, or intracranial hemorrhage (p > 0.05) were found between the early and late CDT groups. Late CDT patients had a higher likelihood of receiving systemic thrombolysis (3.21 [2.18–4.74], p < 0.01), blood transfusion (1.84 [1.41–2.40], p < 0.01), intubation (1.33 [1.05–1.70], p = 0.02), discharge disposition to care facilities (1.32 [1.14–1.53], p < 0.01). and having acute kidney injury (1.42 [1.25–1.61], p < 0.01). Predictors of late intervention were female sex, nonwhite race, and weekend admission (p < 0.01). This study represents a comprehensive evaluation of outcomes associated with the time interval for initiating CDT, revealing reduced morbidity with early intervention. Additionally, it identifies predictors associated with delayed CDT initiation. The broader ramifications of these findings, particularly in relation to hospital resource utilization and health disparities, warrant further exploration. Full article
(This article belongs to the Special Issue Advances in Treatment of Pulmonary Embolism)
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Review

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14 pages, 4488 KiB  
Review
Mechanical Support in High-Risk Pulmonary Embolism: Review Article
by Amer N. Kadri, Razan Alrawashdeh, Mohamad K. Soufi, Adam J. Elder, Zachary Elder, Tamam Mohamad, Eric Gnall and Mahir Elder
J. Clin. Med. 2024, 13(9), 2468; https://doi.org/10.3390/jcm13092468 - 24 Apr 2024
Cited by 3 | Viewed by 3678
Abstract
Acute pulmonary embolism (PE) may manifest with mild nonspecific symptoms or progress to a more severe hemodynamic collapse and sudden cardiac arrest. A substantial thrombotic burden can precipitate sudden right ventricular strain and failure. Traditionally, systemic thrombolytics have been employed in such scenarios; [...] Read more.
Acute pulmonary embolism (PE) may manifest with mild nonspecific symptoms or progress to a more severe hemodynamic collapse and sudden cardiac arrest. A substantial thrombotic burden can precipitate sudden right ventricular strain and failure. Traditionally, systemic thrombolytics have been employed in such scenarios; however, patients often present with contraindications, or these interventions may prove ineffective. Outcomes for this medically complex patient population are unfavorable, necessitating a compelling argument for advanced therapeutic modalities or alternative approaches. Moreover, patients frequently experience complications beyond hemodynamic instability, such as profound hypoxia and multiorgan failure, necessitating assertive early interventions to avert catastrophic consequences. The existing data on the utilization of mechanical circulatory support (MCS) devices are not exhaustive. Various options for percutaneous MCS devices exist, each possessing distinct advantages and disadvantages. There is an imminent imperative to develop a tailored approach for this high-risk patient cohort to enhance their overall outcomes. Full article
(This article belongs to the Special Issue Advances in Treatment of Pulmonary Embolism)
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