Contemporary methods for the treatment of pulmonary embolism — is it prime-time for percutaneous interventions?

Kurzyna, Marcin; Pietrasik, Arkadiusz; Opolski, Grzegorz; Torbicki, Adam

doi:10.5603/kp.a2017.0125

Cited by 8 publications

(8 citation statements)

References 47 publications

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“…[15][16][17] Since it first emerged in the Massachusetts General Hospital in 2013, the PERT -based model of PE management has gained ground not only throughout the United States, but also across Europe and all over the world. [16][17][18][19] Nevertheless, detailed data on institutional experience and preliminary outcomes from PERTs are sparse, especially from Europe. To address this need, we described our experience of the first full year of PERT action at a university hospital.…”

Section: Patient Enrollment and Data Collectionmentioning

confidence: 99%

Implementation of a regional multidisciplinary pulmonary embolism response team: PERT-POZ initial 1-year experience

Sławek-Szmyt¹,

Jankiewicz²,

Smukowska-Gorynia³

et al. 2020

Kardiol Pol

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According to the current European Society of Cardiology guidelines, it is mandatory to initially assess the risk of early death based on clinical and hemodynamic criteria to determine management strategy. 4 Depending on estimated patients' mortality risk, a variety of therapeutic approaches are now INTRODUCTION Pulmonary embolism (PE) is one of the most common cardiovascular diseases, with an estimated global incidence rate of 39 to 115 per 100 000 person-years. 1,2 Pulmonary embolism may be life-threatening with an estimated 30-day mortality rate of 10% to 30%.

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Section: Patient Enrollment and Data Collectionmentioning

confidence: 99%

Implementation of a regional multidisciplinary pulmonary embolism response team: PERT-POZ initial 1-year experience

Sławek-Szmyt¹,

Jankiewicz²,

Smukowska-Gorynia³

et al. 2020

Kardiol Pol

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“…In central PE, it has been shown that the architecture of a surgically removed embolus depends on the location in pulmonary vasculature, with more tightly packed fibrin fibres in segmental pulmonary vessels 13,14 . The compaction of peripheral emboli may in part explain its resistance to endogenous fibrinolysis 15 . We hypothesized that plasma fibrin clots, which are degraded by fibrinolytic enzymes at a higher rate in specific assays, characterize patients with central PE.…”

Section: Introductionmentioning

confidence: 99%

Faster fibrin clot degradation characterizes patients with central pulmonary embolism at a low risk of recurrent peripheral embolism

Kupis

Goldman‐Mazur

Polak

et al. 2019

Sci Rep

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It is unclear whether thrombus location in pulmonary arteries is associated with particular clot characteristics. We assessed 156 patients following either central or peripheral pulmonary embolism (PE). Plasma clot lysis time, the rate of D-dimer release from plasma clots (D-Drate) with the maximum D-dimer concentration achieved (D-Dmax), as well as fibrin formation on turbidimetry, plasma clot permeation, thrombin generation, and fibrinolytic parameters were measured 3–6 months after PE. Patients following central PE (n = 108, 69.3%) were more likely smokers (38.9% vs 18.8%; p = 0.01), less likely carriers of factor XIII Val34Leu allele (40.7% vs 62.5%, p = 0.01), exhibited 16.7% higher D-Drate and 12.7% higher tissue plasminogen activator antigen (tPA:Ag) compared with peripheral PE (p = 0.02 and p < 0.0001, respectively). Saddle PE patients (n = 31, 19.9%) had 11.1% higher D-Drate and 7.3% higher D-Dmax compared with central PE (both p < 0.05). Twenty-three recurrent PE episodes, including 15 central episodes, during a median follow-up of 52.5 months were recorded. Plasma D-dimer and tPA:Ag were independent predictors for central recurrent PE, whereas D-Drate and peak thrombin predicted peripheral recurrent PE. Plasma clots degradation is faster in patients following central PE compared with peripheral PE and fibrinolysis markers might help to predict a type of recurrent PE.

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“…In the published meta-analysis of Bajaj et al [23], periprocedural success, defined as hemodynamic stabilization, reduction of hypoxia and discharge from hospital, was achieved in 87% of patients treated with endovascular treatment. The first Polish experiences with transcatheter methods (AngioJet system, Indigo Penumbra aspiration thrombectomy, EKOS system and Cleaner system) have recently been published [24][25][26][27][28][29].…”

Section: Interventional Therapy In Pementioning

confidence: 99%

Expert opinion on the creating and operating of the regional Pulmonary Embolism Response Teams (PERT). Polish PERT Initiative

Araszkiewicz

Kurzyna²,

Kopeć

et al. 2020

Cardiol J.

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Pulmonary Embolism Response Team (PERT) is a multidisciplinary team established to stratify risk and choose optimal treatment in patients with acute pulmonary embolism (PE). Established for the first time at Massachusetts General Hospital in 2013, PERT is based on a concept combining a Rapid Response Team and a Heart Team. The growing role of PERTs in making individual therapeutic decisions is identified, especially in hemodynamically unstable patients with contraindications to thrombolysis or with co-morbidities, as well as in patients with intermediate-high risk in whom a therapeutic decision may be difficult. The purpose of this document is to define the standards of PERT under Polish conditions, based on the experience of teams already operating in Poland, which formed an agreement called the Polish PERT Initiative. The goals of Polish PERT Initiative are: improving the treatment of patients with PE at local, regional and national levels, gathering, assessing and sharing data on the effectiveness of PE treatment (including various types of catheter-directed therapy), education on optimal treatment of PE, creating expert documents and supporting scientific research, as well as cooperation with other communities and scientific societies.

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Contemporary methods for the treatment of pulmonary embolism — is it prime-time for percutaneous interventions?

Abstract: He is a specialist in internal medicine and cardiology and has a PhD in respiratory medicine. His research interests are currently related to the role of invasive procedures in the diagnosis and treatment of pulmonary vascular diseases.

Cited by 8 publications

References 47 publications

Implementation of a regional multidisciplinary pulmonary embolism response team: PERT-POZ initial 1-year experience

Implementation of a regional multidisciplinary pulmonary embolism response team: PERT-POZ initial 1-year experience

Faster fibrin clot degradation characterizes patients with central pulmonary embolism at a low risk of recurrent peripheral embolism

Expert opinion on the creating and operating of the regional Pulmonary Embolism Response Teams (PERT). Polish PERT Initiative

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