Current state of the interventional approach to acute pulmonary embolism

Massive pulmonary embolism (PE) is a disease with high mortality, therefore early diagnosis and treatment is essential to save lives. In the absence of contraindications, patients with massive PE (high risk) should be treated immediately with full-dose intravenous systemic thrombolysis. The subset of patients for whom systemic thrombolysis is not successful and who continue to present with haemodynamic compromise or those with contraindications may be candidates for various catheter-directed or surgical therapies. The decision algorithm in intermediate-high/submassive risk patients is complex and must be employed by a multidisciplinary team and success may depend on the experience of the medical specialists involved.