Mechanical Support in High-Risk Pulmonary Embolism: Review Article.
Amer N KadriRazan AlrawashdehMohamad K SoufiAdam J ElderZachary ElderTamam MohamadEric GnallMahir ElderPublished in: Journal of clinical medicine (2024)
Acute pulmonary embolism (PE) may manifest with mild nonspecific symptoms or progress to a more severe hemodynamic collapse and sudden cardiac arrest. A substantial thrombotic burden can precipitate sudden right ventricular strain and failure. Traditionally, systemic thrombolytics have been employed in such scenarios; however, patients often present with contraindications, or these interventions may prove ineffective. Outcomes for this medically complex patient population are unfavorable, necessitating a compelling argument for advanced therapeutic modalities or alternative approaches. Moreover, patients frequently experience complications beyond hemodynamic instability, such as profound hypoxia and multiorgan failure, necessitating assertive early interventions to avert catastrophic consequences. The existing data on the utilization of mechanical circulatory support (MCS) devices are not exhaustive. Various options for percutaneous MCS devices exist, each possessing distinct advantages and disadvantages. There is an imminent imperative to develop a tailored approach for this high-risk patient cohort to enhance their overall outcomes.
Keyphrases
- pulmonary embolism
- end stage renal disease
- cardiac arrest
- ejection fraction
- newly diagnosed
- inferior vena cava
- chronic kidney disease
- prognostic factors
- early onset
- patient reported outcomes
- liver failure
- risk factors
- electronic health record
- depressive symptoms
- endothelial cells
- smoking cessation
- adipose tissue
- radiofrequency ablation