Surgical pulmonary embolectomy: state of the art

Zieliński, Dariusz; Dyk, Wojciech; Wróbel, Krzysztof; Biederman, Andrzej

doi:10.5114/kitp.2023.130019

Cited by 2 publications

(1 citation statement)

References 68 publications

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“…It was not until 1961, when Dr. Denton Cooley performed a successful pulmonary embolectomy for acute MPE using a cardiopulmonary bypass machine, that their use for treating MPE gained more recognition. 16 The next year, remarkable outcomes for MPE were reported when 13 of 19 moribund patients survived after receiving a surgical pulmonary embolectomy supported by cardiopulmonary bypass. 17 During this same time, it became clear that a more uniform approach for diagnosing and treating PE was needed.…”

Section: Rethinking Mpementioning

confidence: 99%

From Trendelenburg to PERTs: Evolution in the Management of Massive Pulmonary Embolism

Thangudu

2024

Methodist DeBakey Cardiovascular Journal

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Massive pulmonary embolism (MPE) is a serious condition affecting the pulmonary arteries and is difficult to diagnose, triage, and treat. The American College of Chest Physicians (AHA) and the European Society of Cardiology (ESC) have different classification approaches for PE, with the AHA defining three subtypes and the ESC four. Misdiagnosis is common, leading to delayed or inadequate treatment. The incidence of PE-related death rates has been increasing over the years, and mortality rates vary depending on the subtype of PE, with MPE having the highest mortality rate. The current definition of MPE originated from early surgical embolectomy cases and discussions among experts. However, this definition fails to capture patients at the point of maximal benefit because it is based on late findings of MPE. Pulmonary Embolism Response Teams (PERTs) have emerged as a fundamental shift in the management of MPE, with a focus on high-risk and MPE cases and a goal of rapidly connecting patients with appropriate therapies based on up-to-date evidence. This review highlights the challenges in diagnosing and managing MPE and emphasizes the importance of PERTs and risk stratification scores in improving outcomes for patients with PE.

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Section: Rethinking Mpementioning

confidence: 99%

From Trendelenburg to PERTs: Evolution in the Management of Massive Pulmonary Embolism

Thangudu

2024

Methodist DeBakey Cardiovascular Journal

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Risk Stratification and Management of Intermediate- and High-Risk Pulmonary Embolism

Mojaddedi,

Jamil,

Bishev

et al. 2024

JCM

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Acute pulmonary embolism (PE) is a leading cause of mortality. Not only is PE associated with short-term mortality, but up to ~20% of patients might suffer from long-term consequences such as post-PE syndrome and chronic thromboembolic pulmonary hypertension. Current risk stratification tools poorly predict those who are at risk for short-term deterioration and those who develop long-term consequences. Traditionally, systemic thrombolysis has been considered the first-line therapy for patients with high-risk PE without contraindications; however, it comes with the risk of major bleeding (notably intracranial hemorrhage). The use of catheter-directed interventions (embolectomy or thrombolysis) has been increasing owing to their low bleeding risk; however, randomized trial data supporting their efficacy in improving clinical outcomes are limited. In this review, we highlight the evidence supporting the available advanced therapies for high- and intermediate-risk PE and summarize the ongoing trials which are evaluating these therapies.

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Surgical pulmonary embolectomy: state of the art

Cited by 2 publications

References 68 publications

From Trendelenburg to PERTs: Evolution in the Management of Massive Pulmonary Embolism

From Trendelenburg to PERTs: Evolution in the Management of Massive Pulmonary Embolism

Risk Stratification and Management of Intermediate- and High-Risk Pulmonary Embolism

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