Interventional radiology treatment for pulmonary embolism

Area of Science:

• Cardiology
• Vascular Medicine
• Interventional Radiology

Background:

• Venous thromboembolism (VTE), including pulmonary embolism (PE), is a significant global health concern and a leading cause of death.
• Acute PE carries substantial mortality, particularly in submassive (15%) and massive (68%) cases within three months.
• Current treatment guidelines for PE often rely on fibrinolytic therapy based on clinical severity, but emerging evidence supports more aggressive strategies.

Purpose of the Study:

• To review and summarize current endovascular treatment options for pulmonary embolism.
• To detail the various endovascular techniques, their specific indications, and reported outcomes.
• To provide an overview of advanced treatment modalities for VTE with PE.

Main Methods:

• Systematic literature review of endovascular techniques for PE.
• Analysis of clinical studies and case series on endovascular interventions.
• Comparison of different endovascular approaches, including catheter-directed thrombolysis and thrombectomy.

Main Results:

• Endovascular treatments offer an alternative to systemic fibrinolysis, particularly in high-risk PE patients.
• Specific techniques like catheter-directed thrombolysis and mechanical thrombectomy show promising results in clot removal and hemodynamic improvement.
• Outcomes vary based on technique, patient selection, and institutional experience, with generally lower risks of major bleeding compared to systemic thrombolysis.

Conclusions:

• Endovascular therapies represent a crucial advancement in managing acute pulmonary embolism.
• These minimally invasive techniques provide effective treatment options with potentially improved safety profiles.
• Further research and standardization of endovascular approaches are warranted to optimize PE management.