Current Approach To Pulmonary Embolism

Aims: We planned to provide a systematic review of catheter-based therapies in acute pulmonary embolism (PE). Methods and Results: Studies published in peer-reviewed journals before January 2018 were included and categorised according to the mechanism of thrombus removal: fragmentation, rheolytic therapy, aspiration or catheter-directed thrombolysis. Advantages, challenges and the level of evidence of each device were evaluated. Patients suffering from acute PE, catheter-based therapies are promising options. Most of the procedures are carried using catheter-directed thrombolysis, either ultrasound-assisted or in combination with mechanical fragmentation. Aspiration therapy seems to be promising but sufficient data are not available. Considering the high number of related complications, rheolytic therapy should be applied with caution. Conclusions: Much more detailed research into the efficiency, safety and the cost-effectiveness of the devices are necessary to be conducted. After all, it is high possibility that with proper patient selection, CBT of massive and submassive can improve the results in patients with PE.