1
|
Malerba P, Laera N, Pagnesi M, Bonzi B, Rizzoni D, Metra M, Nardin M. Right ventricular thrombosis: from a case report to pathophysiology mechanisms and current treatment options. J Cardiovasc Med (Hagerstown) 2024; 25:88-94. [PMID: 38064342 DOI: 10.2459/jcm.0000000000001551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Paolo Malerba
- Division of Medicine, Department of Medicine, ASST Spedali Civili, Montichiari
- Department of Clinical and Experimental Sciences, University of Brescia
| | - Nicola Laera
- Department of Clinical and Experimental Sciences, University of Brescia
- Second Medicine Division, Department of Medicine, ASST Spedali Civili
| | | | - Bianca Bonzi
- Division of Medicine, Department of Medicine, ASST Spedali Civili, Montichiari
| | - Damiano Rizzoni
- Division of Medicine, Department of Medicine, ASST Spedali Civili, Montichiari
- Department of Clinical and Experimental Sciences, University of Brescia
| | - Marco Metra
- Division of Cardiology, ASST Spedali Civili
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia
| | - Matteo Nardin
- Department of Biomedical Sciences, Humanitas University, Milan
- Third Medicine Division, Department of Medicine, ASST Spedali Civili, Brescia, Italy
| |
Collapse
|
2
|
Li W, Liu Z, Chen X, Qian Y, Quan R, Xiong C, Gu Q, He J. Right heart thrombus in acute pulmonary embolism: A single center experience in China. Pulm Circ 2023; 13:e12291. [PMID: 37744669 PMCID: PMC10511828 DOI: 10.1002/pul2.12291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/22/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023] Open
Abstract
Right heart thrombus (RHT) is a rare but life-threatening condition in acute pulmonary embolism (APE) without clear management guidelines. This study aimed to address the clinical characteristics and outcomes of RHT-APE in Chinese patients. In this study, 17 RHT-APE and 329 non-RHT-APE patients, who were diagnosed between September 2015 and August 2019, were retrospectively recruited with the median follow-up was 360 days. The overall prevalence of RHT was 4.91% in APE. Its prevalence increased along the increase of APE risk stratifications. Comparisons showed that with higher proportion of male gender and younger age, RHT-APE patients also had worse hemodynamic instability and heart function, and higher risk stratification levels than non-RHT-APE patients. After adjusting by age and gender, multivariate logistic regression analysis found high/intermediate-high risk stratification, decreased right ventricular (RV) motion, NT-proBNP >600 pg/mL, and RV dysfunction were risk factors for RHT. Kaplan-Meier analysis showed non-RHT had better prognosis than RHT patients (30-day survival: log-rank: p < 0.001; 90-day survival: log-rank: p = 0.002). The multivariate logistic regression analysis showed RHT was an independent risk factor for 30-day mortality in APE. The subgroup analysis showed RHT would result in worse outcomes in patients who already had higher APE early mortality risk. RHT would increase the risk of 30- and 90-day mortality in APE. More attention should be paid to young male APE patients with decreased RV motion, NT-proBNP >600 pg/mL, RV dysfunction, or high level of risk stratification, to exclude the coexistence of RHT.
Collapse
Affiliation(s)
- Wen Li
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zhi‐Ying Liu
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiao‐Xi Chen
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yu‐Ling Qian
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Rui‐Lin Quan
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Chang‐Ming Xiong
- State Key Laboratory of Cardiovascular Disease, Center of Pulmonary Vascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Qing Gu
- State Key Laboratory of Cardiovascular Disease, Key Laboratory of Pulmonary Vascular Medicine, Emergency Center, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jian‐Guo He
- State Key Laboratory of Cardiovascular Disease, Center of Pulmonary Vascular Disease, National Center for Cardiovascular Diseases, Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| |
Collapse
|
3
|
Shang M, Kumbasar U, Rajesh B S, Bonde P. Off-pump surgical thrombectomy for subacute right atrial thrombus: A case report. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2023; 31:282-285. [PMID: 37484646 PMCID: PMC10357855 DOI: 10.5606/tgkdc.dergisi.2023.24477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/12/2022] [Indexed: 07/25/2023]
Abstract
Right heart thrombi can be seen in a minority of patients with acute pulmonary embolism and are associated with an increased mortality risk. The optimal treatment option comprises thrombolysis or surgical thrombectomy either with catheterbased interventions or with open surgery. Open right atrial thrombectomy is usually performed under cardiopulmonary bypass due to the need for concomitant pulmonary embolectomy. Nevertheless, cardiopulmonary bypass has major drawbacks such as the risk of stroke, coagulopathy, and myocardial and respiratory dysfunction, particularly in high-risk patients. Herein, we report a case of successful off-pump surgical thrombectomy performed for the right atrial clot-in-transit following failure of the catheter-based intervention.
Collapse
Affiliation(s)
- Michael Shang
- Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, USA
| | - Ulas Kumbasar
- Department of Thoracic Surgery, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Sekar Rajesh B
- Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, USA
| | - Pramod Bonde
- Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, USA
| |
Collapse
|
4
|
Feng Y, Wang Y, Li X, Mao H. Anticoagulation therapy for pulmonary embolism involving a myxoma mimicking, giant type C thrombus: a case report. J Biomed Res 2022; 37:148-152. [PMID: 36058837 PMCID: PMC10018411 DOI: 10.7555/jbr.36.20220118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Right heart thrombus (RHTh) with concurrent acute pulmonary embolism (PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh (type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography (TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.
Collapse
Affiliation(s)
- Yinhe Feng
- Department of Respiratory and Critical Care Medicine, People's Hospital of Deyang City, Affiliated Hospital of Chengdu College of Medicine, Deyang, Sichuan 618000, China.,Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yubin Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaolong Li
- Department of Respiratory and Critical Care Medicine, People's Hospital of Deyang City, Affiliated Hospital of Chengdu College of Medicine, Deyang, Sichuan 618000, China
| | - Hui Mao
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| |
Collapse
|
5
|
Khosla A, Mojibian H, Assi R, Tantawy H, Singh I, Pollak J. Right heart thrombi (RHT) and clot in transit with concomitant PE management: Approach and considerations. Pulm Circ 2022; 12:e12080. [PMID: 35514771 PMCID: PMC9063956 DOI: 10.1002/pul2.12080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/04/2022] [Accepted: 04/06/2022] [Indexed: 11/06/2022] Open
Abstract
Right heart thrombi (RHT) continues to pose a clinical dilemma for multiple specialties and is especially concerning when present with concomitant pulmonary embolism (PE). Patients with PE and RHT are at an increased risk of poor outcomes compared to PE without RHT. Although the exact incidence of RHT is unknown, the increasing use of point-of-care ultrasound may lead to an increased detection and frequency of RHT. There are multiple treatment strategies available for RHT, including anticoagulation, systemic thrombolysis, and endovascular and surgical therapies. Given that these treatment strategies involve multiple medical specialties, the management of RHT with concomitant PE can be complex. Currently, there is limited clinical data and guidelines on the treatment and management of RHT. We aim to provide a review on RHT with concomitant PE, including risk stratification, treatment considerations, and our approach to the management of RHT.
Collapse
Affiliation(s)
- Akhil Khosla
- Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of MedicineYale New Haven HospitalNew‐HavenConnecticutUSA
| | - Hamid Mojibian
- Department of Radiology and Biomedical Imaging, Section of Vascular and Interventional RadiologyYale University School of MedicineNew HavenConnecticutUSA
| | - Roland Assi
- Division of Cardiac SurgeryYale University School of MedicineNew HavenConnecticutUSA
| | - Hossam Tantawy
- Department of AnesthesiologyYale University School of MedicineNew HavenConnecticutUSA
| | - Inderjit Singh
- Department of Internal Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Yale University School of MedicineYale New Haven HospitalNew‐HavenConnecticutUSA
| | - Jeffrey Pollak
- Department of Radiology and Biomedical Imaging, Section of Vascular and Interventional RadiologyYale University School of MedicineNew HavenConnecticutUSA
| |
Collapse
|
6
|
Sakellariou XM, Efstathopoulos A, Stamatis KV, Nikas DN, Kolettis TM. Treatment of Mobile Right Heart Thrombi. Eur J Case Rep Intern Med 2020; 7:001918. [PMID: 33313001 PMCID: PMC7727624 DOI: 10.12890/2020_001918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 08/14/2020] [Indexed: 11/11/2022] Open
Abstract
Right heart thrombi are detected in approximately 4% of patients with pulmonary embolism. The associated mortality is high, but the optimal strategy remains controversial. We report a case of a large mobile right heart thrombus, complicated by embolism of the right pulmonary artery, which was successfully treated with half-dose alteplase. We briefly review the literature and discuss the therapeutic options, focusing on the advantages of thrombolysis.
Collapse
Affiliation(s)
- Xenofon M Sakellariou
- 1st Cardiology Department, School of Medicine, University of Ioannina, Ioannina. Greece
| | | | | | - Dimitrios N Nikas
- 1st Cardiology Department, School of Medicine, University of Ioannina, Ioannina. Greece
| | - Theofilos M Kolettis
- 1st Cardiology Department, School of Medicine, University of Ioannina, Ioannina. Greece
| |
Collapse
|
7
|
Saegusa K, Yoshikawa S, Ueda T. Elderly woman in cardiopulmonary arrest. J Am Coll Emerg Physicians Open 2020; 1:1734-1735. [PMID: 33392584 PMCID: PMC7771787 DOI: 10.1002/emp2.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kazusa Saegusa
- Department of Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoKyotoJapan
| | - Satoshi Yoshikawa
- Department of Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoKyotoJapan
| | - Takeshi Ueda
- Department of Emergency and General Internal MedicineRakuwakai Marutamachi HospitalKyotoKyotoJapan
| |
Collapse
|
8
|
Mayà-Casalprim G, Rodríguez-Vázquez A, Sarto J, Llull L. Trombo flotante en cavidades cardíacas derechas causante de embolismo pulmonar en paciente con ictus isquémico agudo. Caso clínico y revisión de la literatura. Neurologia 2020; 35:661-663. [DOI: 10.1016/j.nrl.2019.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/07/2019] [Accepted: 08/01/2019] [Indexed: 11/26/2022] Open
|
9
|
Mayà-Casalprim G, Rodríguez-Vázquez A, Sarto J, Llull L. Floating right heart thrombus causing pulmonary embolism in a patient with acute ischaemic stroke: A case report and review of literature. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2019.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
10
|
Lari A, Abdulshakoor A, Zogheib E, Assaf N, Mojallal A, Lari AR, Bauer C, Sinna R. How to Save a Life From Macroscopic Fat Embolism: A Narrative Review of Treatment Options. Aesthet Surg J 2020; 40:1098-1107. [PMID: 31606739 DOI: 10.1093/asj/sjz277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Macroscopic fat embolism (MAFE) has grabbed the attention of the plastic surgery community in recent years because of its high mortality rate. Many articles on preventing MAFE during gluteal fat grafting are available in the literature. However, total prevention is difficult: a number of factors, both technical and human, mean that MAFE remains a potential complication. This review was written with the main goal of providing a treatment plan. MAFE shares many similar pathophysiologic and hemodynamic features with massive thrombotic pulmonary embolism (PE), especially the associated cardiopulmonary decompensation. Lessons learned from PE management were used to devise a management algorithm for MAFE. The use of extracorporeal membrane oxygenation and its potential application as a main modality of treatment for MAFE was explored. The lack of evidence in the literature for the treatment of MAFE, and its high mortality, lent urgency to the need to write an article on the management aspect in the form of a narrative review, to ensure that every plastic surgeon practicing gluteal fat grafting is knowledgeable about the treatment aspect of this deadly complication.
Collapse
Affiliation(s)
- Aqeel Lari
- University Hospital of Amiens and University Hospital of Lyon, Lyon, France
- plastic and reconstructive surgeon in private practice in Hawally, Kuwait
| | - Abeer Abdulshakoor
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Amiens, Amiens, France
| | | | - Nizar Assaf
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Amiens, Amiens, France
| | | | - Abdul-Reda Lari
- plastic and reconstructive surgeon in private practice in Hawally, Kuwait
| | - Christian Bauer
- Croix Rousse Hospital, University Hospital of Lyon, Lyon, France
| | - Raphael Sinna
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Amiens, Amiens, France
| |
Collapse
|
11
|
Kalivoda EJ, Rivera Rodriguez K, Cabrera G. Right Heart Thrombus in Transit Diagnosed With Focused Cardiac Ultrasound in the Emergency Department. Cureus 2020; 12:e9354. [PMID: 32850226 PMCID: PMC7444960 DOI: 10.7759/cureus.9354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The diagnosis of a right heart thrombus (RHTh) in transit associated with pulmonary embolism (PE) is an uncommon phenomenon with a high mortality rate. Timely recognition of RHTh with focused cardiac ultrasound (FOCUS) in cases of suspected PE is necessary for critical decision making in the emergency department (ED). We present a case of RHTh with submassive PE in which the patient underwent successful catheter-directed thrombolysis. This case report illustrates the significance of an emergency physician (EP) implementing FOCUS during the initial ED evaluation to rapidly diagnose RHTh in transit and initiate PE therapy without delay.
Collapse
Affiliation(s)
- Eric J Kalivoda
- Emergency Medicine, Hospital Corporation of America West Florida Graduate Medical Education Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA
| | - Kevin Rivera Rodriguez
- Emergency Medicine, Hospital Corporation of America West Florida Graduate Medical Education Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA
| | - Gabriel Cabrera
- Emergency Medicine, Hospital Corporation of America West Florida Graduate Medical Education Consortium/Brandon Regional Hospital, University of South Florida Morsani College of Medicine, Brandon, USA
| |
Collapse
|
12
|
Kaitalidou E, Karapiperis D, Makrakis V, Kipourou M, Petroglou D. Acute Massive Pulmonary Embolism with Direct Visualization of a Free-floating Right Heart Thrombus Successfully Treated with Fibrinolysis: A Case Report. Prague Med Rep 2020; 121:42-48. [PMID: 32191619 DOI: 10.14712/23362936.2020.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
A male patient with a history of immobilization due to motor weakness, was transferred to our emergency department after syncope during physiotherapy, with recorded hypotension. Transthoracic echocardiography showed severe dilatation of the right ventricle (RV), with apex hypercontractility and almost akinetic RV free wall. The above findings, in addition to the unexpected visualization of a large, free-floating, right atrial thrombus, a rare finding associated with high mortality, readily confirmed the clinical suspicion of acute pulmonary embolism (PE) causing circulatory collapse. Intravenous fibrinolysis and vasopressor therapy were successfully administered, and hemodynamic instability was soon alleviated.
Collapse
Affiliation(s)
- Elisavet Kaitalidou
- Department of Internal Medicine, 424 General Military Hospital, Thessaloniki, Greece
| | - Dimitrios Karapiperis
- Department of Infectious Diseases, 424 General Military Hospital, Thessaloniki, Greece
| | - Vasileios Makrakis
- Intensive Care Unit, 424 General Military Hospital, Thessaloniki, Greece
| | - Maria Kipourou
- Department of Pulmonology, 424 General Military Hospital, Thessaloniki, Greece
| | - Dimitrios Petroglou
- Coronary Care Unit, Department of Cardiology, 424 General Military Hospital, Thessaloniki, Greece.
| |
Collapse
|
13
|
Kabrhel C, Rosovsky R, Garvey S. Special Considerations in Pulmonary Embolism: Clot-in-Transit and Incidental Pulmonary Embolism. Crit Care Clin 2020; 36:531-546. [PMID: 32473697 DOI: 10.1016/j.ccc.2020.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
This article describes 2 relatively rare, but complex situations in pulmonary embolism (PE): clot-in-transit (CIT), incidental PE (IPE). CIT describes a venous thromboembolism that has become lodged in the right heart. CIT is associated with high mortality and presents unique challenges in management. Incidental PE (IPE) describes PE diagnosed on imaging performed for another indication. The treatment is complex because there is often a disconnect between the PE severity on imaging and lack of severity of the clinical presentation. We summarize the available literature and aid clinicians as they manage patients with PE across the clinical severity spectrum.
Collapse
Affiliation(s)
- Christopher Kabrhel
- Department of Emergency Medicine, Center for Vascular Emergencies, Massachusetts General Hospital, Harvard Medical School, Zero Emerson Place, Suite 3B, Boston, MA 02114, USA.
| | - Rachel Rosovsky
- Division of Hematology, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Shannon Garvey
- Boston University School of Medicine, 72 E Concord Street, Boston, MA 02118, USA
| |
Collapse
|
14
|
Rivera-Lebron B, McDaniel M, Ahrar K, Alrifai A, Dudzinski DM, Fanola C, Blais D, Janicke D, Melamed R, Mohrien K, Rozycki E, Ross CB, Klein AJ, Rali P, Teman NR, Yarboro L, Ichinose E, Sharma AM, Bartos JA, Elder M, Keeling B, Palevsky H, Naydenov S, Sen P, Amoroso N, Rodriguez-Lopez JM, Davis GA, Rosovsky R, Rosenfield K, Kabrhel C, Horowitz J, Giri JS, Tapson V, Channick R. Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium. Clin Appl Thromb Hemost 2019; 25:1076029619853037. [PMID: 31185730 PMCID: PMC6714903 DOI: 10.1177/1076029619853037] [Citation(s) in RCA: 129] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations in recommendations by different clinical guidelines, as well as lack of robust clinical trials, make clinical decisions challenging. The Pulmonary Embolism Response Team Consortium is an international association created to advance the diagnosis, treatment, and outcomes of patients with PE. In this consensus practice document, we provide a comprehensive review of the diagnosis, treatment, and follow-up of acute PE, including both clinical data and consensus opinion to provide guidance for clinicians caring for these patients.
Collapse
Affiliation(s)
| | | | - Kamran Ahrar
- 3 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Abdulah Alrifai
- 4 University of Miami of Palm Beach Regional Campus/JFK Hospital, Atlantis, FL, USA
| | - David M Dudzinski
- 5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Danielle Blais
- 7 The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Roman Melamed
- 9 Abbott Northwestern Hospital, Minneapolis, MN, USA
| | | | - Elizabeth Rozycki
- 7 The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | | | - Parth Rali
- 10 Temple University, Philadelphia, PA, USA
| | | | | | | | | | | | - Mahir Elder
- 14 Wayne State University, Detroit, MI, USA.,15 Michigan State University, East Lansing, MI, USA
| | | | | | | | | | | | | | | | - Rachel Rosovsky
- 5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kenneth Rosenfield
- 5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Jay S Giri
- 16 University of Pennsylvania, Philadelphia, PA, USA
| | - Victor Tapson
- 21 Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | |
Collapse
|