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Cutting-Edge Techniques and Drugs for the Treatment of Pulmonary Embolism: Current Knowledge and Future Perspectives.
Falsetti, Lorenzo; Guerrieri, Emanuele; Zaccone, Vincenzo; Viticchi, Giovanna; Santini, Silvia; Giovenali, Laura; Lagonigro, Graziana; Carletti, Stella; Gialluca Palma, Linda Elena; Tarquinio, Nicola; Moroncini, Gianluca.
Afiliação
  • Falsetti L; Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Guerrieri E; Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Zaccone V; Internal and Subintensive Medicine, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy.
  • Viticchi G; Clinica di Neurologia, Dipartimento Scienze Cliniche e Molecolare, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Santini S; Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Giovenali L; Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Lagonigro G; Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Carletti S; Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Gialluca Palma LE; Internal Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy.
  • Tarquinio N; Internal Medicine Department, INRCA-IRCCS Osimo-Ancona, 60027 Ancona, Italy.
  • Moroncini G; Clinica Medica, Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, 60126 Ancona, Italy.
J Clin Med ; 13(7)2024 Mar 28.
Article em En | MEDLINE | ID: mdl-38610717
ABSTRACT
Pulmonary embolism (PE) is a potentially life-threatening condition requiring prompt diagnosis and treatment. Recent advances have led to the development of newer techniques and drugs aimed at improving PE management, reducing its associated morbidity and mortality and the complications related to anticoagulation. This review provides an overview of the current knowledge and future perspectives on PE treatment. Anticoagulation represents the first-line treatment of hemodynamically stable PE, direct oral anticoagulants being a safe and effective alternative to traditional anticoagulation these drugs have a rapid onset of action, predictable pharmacokinetics, and low bleeding risk. Systemic fibrinolysis is suggested in patients with cardiac arrest, refractory hypotension, or shock due to PE. With this narrative review, we aim to assess the state of the art of newer techniques and drugs that could radically improve PE management in the near future (i) mechanical thrombectomy and pulmonary embolectomy are promising techniques reserved to patients with massive PE and contraindications or failure to systemic thrombolysis; (ii) catheter-directed thrombolysis is a minimally invasive approach that can be suggested for the treatment of massive or submassive PE, but the lack of large, randomized controlled trials represents a limitation to widespread use; (iii) novel pharmacological approaches, by agents inhibiting thrombin-activatable fibrinolysis inhibitor, factor Xia, and the complement cascade, are currently under investigation to improve PE-related outcomes in specific settings.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2024 Tipo de documento: Article