Abstract
Pulmonary embolus (PE) is defined as obstruction of the pulmonary artery or one of
its branches by material (e.g., thrombus, tumor, air, or fat) but most commonly due
to thrombus originating from the lower extremity deep veins.
We reviewed the current literature describing the optimal medical treatment and management
of PE.
Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL)
were searched for relevant studies and guidelines for management of patients with
PE.
The initial approach to patients with suspected PE should focus upon stabilizing the
patient while further workup for risk stratification is in progress. In most cases,
anticoagulation should ideally be started even prior to confirming PE, if risk–benefit
regarding suspicion of PE and bleeding risk is favorable.
Once the diagnosis is confirmed, risk stratification will guide further therapies
consisting of anticoagulation, thrombolysis, or catheter-directed interventions. Data
for initial, long-term, and indefinite anticoagulation, and factors that determine
whether or not a patient can be treated in the outpatient setting, are reviewed and
discussed.
Keywords
pulmonary embolism - anticoagulation - thrombolytic - pharmacotherapy - risk stratification
