[Role of mechanical thrombectomy in the management of acute pulmonary embolism]

Venous thromboembolism disease complicated by pulmonary embolism is a common cause of admission to emergencies and critical care unit. It is burdened by high mortality in the absence of early and appropriate treatment. Rapid diagnosis, anticoagulation to avoid recurrence and, in case of hemodynamic instability, use of systemic fibrinolysis are the corner stones of its management. For several years, interventional radiology techniques have been developed to treat the most critical patients in addition to or instead of systemic fibrinolysis. Among these techniques, mechanical thrombectomy deserves to be integrated into our therapeutic arsenal. We propose here an original decision-making algorithm integrating this technique based on a review of the literature, with the support of multidisciplinary team for the management of pulmonary embolism in our department.