Semin Respir Crit Care Med 2021; 42(02): 250-262
DOI: 10.1055/s-0040-1722291
Review Article

Aggressive Therapy for Acute Pulmonary Embolism: Systemic Thrombolysis and Catheter-Directed Approaches

Thomas M. Todoran
1  Division of Cardiovascular Medicine, Medical University of South Carolina, Charleston, South Carolina
Bradley Petkovich
2  Divisions of Pulmonary and Critical Care, Medical University of South Carolina, Charleston, South Carolina
› Author Affiliations


Venous thromboembolism (VTE) is the third most common cause of cardiovascular disease after myocardial infarction and stroke. Population-based studies estimate that up to 94,000 new cases of pulmonary embolism (PE) occur in the United States annually with an increasing incidence with age. Mortality from PE is the greatest in the first 24 hours, with a decreased survival extending out 3 months. Thus, acute PE is a potentially fatal illness if not recognized and treated in a timely manner. Contemporary management includes systemic anticoagulation, thrombolysis, catheter-based procedures, and surgical embolectomy. This article reviews current clinical evidence and societal guidelines for the use of systemic and catheter-directed thrombolysis for treatment of acute PE.

Publication History

Publication Date:
06 February 2021 (online)

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