Temporary Mechanical Circulatory Support in Pulmonary Embolism

This article highlights the limitations of thrombolysis in high-risk pulmonary embolism and the emerging role of temporary mechanical circulatory support, especially venoarterial extracorporeal membrane oxygenation, as a bridge to recovery or definitive therapy. The pathophysiology of right ventricular failure in pulmonary embolism, risk stratification strategies, and decision-making frameworks for initiating mechanical circulatory support are reviewed. Further, we cover practical considerations, including device selection, circuit management during thrombectomy, and the imperative for preanesthesia planning in risk mitigation. Finally, this article highlights the importance of conducting prospective and randomized studies on device choice, timing, and integration with reperfusion strategies.