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Management of high and intermediate-high risk pulmonary embolism: A position paper of the Interventional Cardiology Working Group of the Italian Society of Cardiology.
Andò, Giuseppe; Pelliccia, Francesco; Saia, Francesco; Tarantini, Giuseppe; Fraccaro, Chiara; D'Ascenzo, Fabrizio; Zimarino, Marco; Di Marino, Mario; Niccoli, Giampaolo; Porto, Italo; Calabrò, Paolo; Gragnano, Felice; De Rosa, Salvatore; Piccolo, Raffaele; Moscarella, Elisabetta; Fabris, Enrico; Montone, Rocco Antonio; Spaccarotella, Carmen; Indolfi, Ciro; Sinagra, Gianfranco; Perrone Filardi, Pasquale.
Afiliación
  • Andò G; Department of Clinical and Experimental Medicine, University of Messina, AOU Policlinico "Gaetano Martino", Messina, Italy.
  • Pelliccia F; Department of Cardiovascular Sciences, "La Sapienza" University, Rome, Italy. Electronic address: f.pelliccia@mclink.it.
  • Saia F; Department of Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Bologna, Italy.
  • Tarantini G; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.
  • Fraccaro C; Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, Padua, Italy.
  • D'Ascenzo F; Division of Cardiology, Cardiovascular and Thoracic Department, Città della Salute e della Scienza Hospital and University of Turin, Turin, Italy.
  • Zimarino M; Department of Neuroscience, Imaging and Clinical Sciences, "Gabriele D'Annunzio" University of Chieti-Pescara, Chieti, Italy; Department of Cardiology, "SS. Annunziata Hospital", ASL 2 Abruzzo, Chieti, Italy.
  • Di Marino M; Department of Neuroscience, Imaging and Clinical Sciences, "Gabriele D'Annunzio" University of Chieti-Pescara, Chieti, Italy.
  • Niccoli G; Department of Medicine and Surgery, University of Parma, Parma, Italy.
  • Porto I; Chair of Cardiovascular Disease, Department of Internal Medicine and Specialties, University of Genoa, Genoa, Italy; Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV) IRCCS, Ospedale Policlinico San Martino, Genoa, Italy.
  • Calabrò P; Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Italy; Division of Clinical Cardiology, AORN "Sant'Anna e San Sebastiano", Caserta, Italy.
  • Gragnano F; Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Italy; Division of Clinical Cardiology, AORN "Sant'Anna e San Sebastiano", Caserta, Italy.
  • De Rosa S; Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
  • Piccolo R; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
  • Moscarella E; Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Italy; Division of Clinical Cardiology, AORN "Sant'Anna e San Sebastiano", Caserta, Italy.
  • Fabris E; Cardio-thoraco-vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.
  • Montone RA; Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
  • Spaccarotella C; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
  • Indolfi C; Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy.
  • Sinagra G; Cardio-thoraco-vascular Department, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), University of Trieste, Trieste, Italy.
  • Perrone Filardi P; Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Int J Cardiol ; 400: 131694, 2024 Apr 01.
Article en En | MEDLINE | ID: mdl-38160911
ABSTRACT
Pulmonary embolism (PE) is a potentially life-threatening condition that remains a major global health concern. Noteworthy, patients with high- and intermediate-high-risk PE pose unique challenges because they often display clinical and hemodynamic instability, thus requiring rapid intervention to mitigate the risk of clinical deterioration and death. Importantly, recovery from PE is associated with long-term complications such as recurrences, bleeding with oral anticoagulant treatment, pulmonary hypertension, and psychological distress. Several novel strategies to improve risk factor characterization and management of patients with PE have recently been introduced. Accordingly, this position paper of the Working Group of Interventional Cardiology of the Italian Society of Cardiology deals with the landscape of high- and intermediate-high risk PE, with a focus on bridging the gap between the evolving standards of care and the current clinical practice. Specifically, the growing importance of catheter-directed therapies as part of the therapeutic armamentarium is highlighted. These interventions have been shown to be effective strategies in unstable patients since they offer, as compared with thrombolysis, faster and more effective restoration of hemodynamic stability with a consistent reduction in the risk of bleeding. Evolving standards of care underscore the need for continuous re-assessment of patient risk stratification. To this end, a multidisciplinary approach is paramount in refining selection criteria to deliver the most effective treatment to patients with unstable hemodynamics. In conclusion, the current management of unstable patients with PE should prioritize tailored treatment in a patient-oriented approach in which transcatheter therapies play a central role.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Cardiología Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embolia Pulmonar / Cardiología Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Países Bajos