Treatment of acute pulmonary embolism: anticoagulation, fibrinolysis, and thrombectomy compared.

Acute pulmonary embolism represents a major clinical challenge, characterized by a wide spectrum of phenotypic presentations ranging from asymptomatic disease to cardiovascular collapse. Therapeutic management has evolved from a dichotomous paradigm (anticoagulation vs. thrombolysis) to a risk-stratified approach based on early mortality risk and right ventricular function. This article critically reviews current evidence regarding parenteral and oral anticoagulation, systemic thrombolysis, and emerging catheter-directed thrombectomy techniques, in light of the 2019 European Society of Cardiology guidelines and recent clinical trials.