Challenges and considerations in the management of acute pulmonary embolism: a critical analysis of European Society of Cardiology guidelines

  • Slobodan Obradović Military Medical Academy, *Clinic of Cardiology, University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Boris Džudović Military Medical Academy, Clinic of Emergency Internal Medicine, Belgrade, Serbia University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Tamara Simpson Jacobi/North Central Bronx Hospital, New York, New York, USA
Keywords: heart arrest;, practice guidelines as topic;, pulmonary embolism;, therapeutics;, thrombolytic therapy.

References

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in col-laboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41(4): 543–603.

Oh JK, Park JH. Role of echocardiography in acute pulmonary embolism. Korean J Intern Med 2023; 38(4): 456–70.

Mahboob HB, Denney BW. Double Bolus Alteplase Therapy during Cardiopulmonary Resuscitation for Cardiac Arrest due to Massive Pulmonary Embolism Guided by Focused Bedside Echocardiography. Case Rep Crit Care 2018; 2018: 7986087.

O’Connor G, Fitzpatrick G, El-Gammal A, Gilligan P. Double Bolus Thrombolysis for Suspected Massive Pulmonary Embo-lism during Cardiac Arrest. Case Rep Emerg Med 2015; 2015: 367295.

British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax 2003; 58(6): 470–83.

Lavonas EJ, Drennan IR, Gabrielli A, Heffner AC, Hoyte CO, Orkin AM, et al. Part 10: Special Circumstances of Resuscita-tion: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascu-lar Care. Circulation 2015; 132(18 Suppl 2): S501–18.

Yin Q, Li X, Li C. Thrombolysis after initially unsuccessful cardiopulmonary resuscitation in presumed pulmonary embo-lism. Am J Emerg Med 2015; 33(1): 132.e1–2.

Ismayl M, Machanahalli Balakrishna A, Aboeata A, Gupta T, Young MN, Altin SE, et al. Meta-Analysis Comparing Cathe-ter-Directed Thrombolysis Versus Systemic Anticoagulation Alone for Submassive Pulmonary Embolism. Am J Cardiol 2022; 178: 154–62.

Sekulic I, Dzudovic B, Matijasevic J, Batranovic U, Rusovic S, Mihaj-lovic M, et al. Ultrasound assisted thrombolysis in intermedi-ate-risk patients with pulmonary thromboembolism. Acta Cardiol 2020; 75(7): 623–30.

Pruszczyk P, Kopeć G. Catheter directed therapies: an option for elderly frail patients with pulmonary embolism requiring reperfusion. EuroIntervention 2023; 19(9): 708–9.

Gonsalves CF, Gibson CM, Stortecky S, Alvarez RA, Beam DM, Horowitz JM, et al. Randomized controlled trial of mechanical thrombectomy vs catheter-directed thrombolysis for acute hemodynamically stable pulmonary embolism: Rationale and design of the PEERLESS study. Am Heart J 2023; 266: 128–37.

Sista AK, Horowitz JM, Tapson VF, Rosenberg M, Elder MD, Schiro BJ, et al. Indigo Aspiration System for Treatment of Pulmonary Embolism: Results of the EXTRACT-PE Trial. JACC Cardiovasc Interv 2021; 14(3): 319–29.

Ružičić DP, Dzudovic B, Matijasevic J, Benic M, Salinger S, Kos L, et al. Signs and symptoms of acute pulmonary embolism and their predictive value for all-cause hospital death in respect of severity of the disease, age, sex and body mass index: retro-spective analysis of the Regional PE Registry (REPER). BMJ Open Respir Res 2023; 10(1): e001559.

Morrone D, Morrone V. Acute Pulmonary Embolism: Focus on the Clinical Picture. Korean Circ J 2018; 48(5): 365–81. Er-ratum in: Korean Circ J 2018; 48(7): 661-3.

Obradovic S, Dzudovic B, Subotic B, Salinger S, Matijasevic J, Benic M, et al. Association of Blood Leukocytes and Hemoglobin with Hospital Mortality in Acute Pulmonary Embolism. J Clin Med 2023; 12(19): 6269.

Dzudovic B, Simpson T, Djuric I, Subotic B, Matijasevic J, Dzudovic J, et al. The significance of B-type natriuretic peptide in pre-dicting early mortality among pulmonary embolism patients, alongside troponin: insights from a multicentric registry. Curr Probl Cardiol 2024; 49(4): 102437.

Obradovic S, Subotic B, Dzudovic B, Matijasevic J, Dzudovic J, Salin-ger-Martinovic S, et al. Pulmonary embolism bleeding score in-dex (PEBSI): A new tool for the detection of patients with low risk for major bleeding on thrombolytic therapy. Thromb Res 2022; 214: 138–43.

Glazier JJ, Patiño-Velasquez S, Oviedo C. The Pulmonary Embo-lism Response Team: Rationale, Operation, and Outcomes. Int J Angiol 2022; 31(3): 198–202.

Agnelli G, Buller HR, Cohen A, Curto M, Gallus AS, Johnson M, et al. Oral Apixaban for the Treatment of Acute Venous Thromboembolism. N Engl J Med 2013; 369(9): 799–808.

Schulman S, Kearon C, Kakkar AK, Mismetti P, Schellong S, Eriks-son H, et al. Dabigatran versus Warfarin in the Treatment of Acute Venous Thromboembolism. N Engl J Med 2009; 361(24): 2342–52.

EINSTEIN Investigators; Bauersachs R, Berkowitz SD, Brenner B, Buller HR, Decousus H, et al. Oral rivaroxaban for symptomat-ic venous thromboembolism. N Engl J Med 2010; 363(26): 2499–510.

Hokusai-VTE Investigators; Büller HR, Décousus H, Grosso MA, Mercuri M, Middeldorp S, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med 2013; 369(15): 1406–15. Erratum in: N Engl J Med 2014; 370(4): 390.

EINSTEIN–PE Investigators; Büller HR, Prins MH, Lensin AW, Decousus H, Jacobson BF, et al. Oral rivaroxaban for the treat-ment of symptomatic pulmonary embolism. N Engl J Med 2012; 366(14): 1287–97.

Su X, Yan B, Wang L, Cheng H, Chen Y. Comparative efficacy and safety of oral anticoagulants for the treatment of venous thromboembolism in the patients with different renal func-tions: a systematic review, pairwise and network meta-analysis. BMJ Open 2022; 12(2): e048619.

Fahrni J, Husmann M, Gretener SB, Keo HH. Assessing the risk of recurrent venous thromboembolism--a practical approach. Vasc Health Risk Manag 2015; 11: 451–9.

Prins MH, Lensing AWA, Prandoni P, Wells PS, Verhamme P, Beyer-Westendorf J, et al. Risk of recurrent venous thromboem-bolism according to baseline risk factor profiles. Blood Adv 2018; 2(7): 788–96.

Klok FA, Hösel V, Clemens A, Yollo WD, Tilke C, Schulman S, et al. Prediction of bleeding events in patients with venous thromboembolism on stable anticoagulation treatment. Eur Respir J 2016; 48(5): 1369–76.

Published
2024/11/29
Section
Current Topic