Review of Interventional Options and Surgical Techniques in the Management of Acute Pulmonary Embolism.

INTRODUCTION

Acute massive pulmonary embolism (PE) represents a potentially lethal condition causing acute right ventricular heart dysfunction and cardiogenic shock. We aim to provide an overview of interventional and surgical options for PE management, with a focus on surgical techniques and outcomes.

METHODS

This was a narrative review so a systematic literature search was not performed.

RESULTS

Catheter-directed thrombolysis and catheter-directed mechanical thrombectomy have demonstrated improved outcomes in several recent trials compared to medical management alone for higher risk PE. Surgical pulmonary embolectomy techniques have also evolved greatly over the years. Both in-hospital and short-term outcomes after surgical management show significant improvement from historical data that have limited the widespread acceptance of surgical management for acute PE. Veno-arterial extracorporeal membrane oxygenation has also emerged as a potential strategy to bridge high risk patients to definitive therapies.

CONCLUSIONS

Surgical pulmonary embolectomy has gained popularity in recent years for PE management, with evolving techniques and improving outcomes compared to historical data. A thorough understanding of interventional and surgical techniques and options, combined with a multidisciplinary approach to care, are crucial to ensure timely and effective management of patients with acute PE.