Mechanical Support in High-Risk Pulmonary Embolism: Review Article

Area of Science:

• Cardiology
• Pulmonology
• Critical Care Medicine

Background:

• Acute pulmonary embolism (PE) presents a spectrum of severity, from mild symptoms to life-threatening hemodynamic collapse and cardiac arrest.
• Significant thrombotic burden in PE can lead to acute right ventricular strain and failure.
• Traditional systemic thrombolytics are often contraindicated or ineffective in severe PE cases.

Purpose of the Study:

• To highlight the limitations of current treatments for acute pulmonary embolism (PE).
• To emphasize the need for advanced therapeutic modalities, including mechanical circulatory support (MCS) devices.
• To advocate for a tailored approach to improve outcomes in high-risk PE patients.

Main Methods:

• Review of existing literature on acute pulmonary embolism (PE) management.
• Analysis of the role and limitations of systemic thrombolytics.
• Exploration of percutaneous mechanical circulatory support (MCS) device options.

Main Results:

• Severe PE can lead to profound hypoxia and multiorgan failure beyond hemodynamic instability.
• Existing data on mechanical circulatory support (MCS) for PE is limited.
• Various percutaneous MCS devices offer distinct advantages and disadvantages.

Conclusions:

• There is an urgent need for advanced therapeutic strategies for severe acute pulmonary embolism (PE).
• Mechanical circulatory support (MCS) represents a promising alternative or adjunctive therapy.
• Developing a tailored approach for high-risk PE patients is imperative to enhance survival and recovery.