Update Lungenarterienembolie

ZUSAMMENFASSUNG

Die korrekte Behandlung der Lungenarterienembolie beginnt mit einer frühzeitigen multimodalen Einschätzung des Risikos unter Berücksichtigung der klinischen Vorhersagekraft, Laborparametern und bildmorphologischen Risikomerkmalen. Während die Lysetherapie hauptsächlich Patienten mit Schocksituation vorbehalten ist, kann sie bei ausgewählten stabilen Patienten mit intermediär hohem Risiko und vertretbarem Blutungsrisiko ebenfalls in Betracht gezogen werden. Im Niedrigrisikobereich ist eine ambulante Behandlung vertretbar. Neue Aspekte umfassen auch den Einsatz von kathetergestützen Reperfusionsmaßnahmen, sowie Algorithmen, um das Langzeitrezidivrisiko als auch die Entwicklung einer chronisch thrombembolischen pulmonalen Hypertonie frühzeitig zu erkennen. Der Vorteil der verlängerten Sekundärprophylaxe nach Lungenarterienembolie ist bei bestimmten Patienten durch Anwendung von klinischen Vorhersagemodellen und auch im Bereich der Tumorerkrankungen durch aktuelle Studiendaten belegt worden. Dieser Übersichtsartikel dient als Update unter Berücksichtigung der aktuellen Entwicklung und liefert Perspektiven über derzeit laufende Studien zur Klärung von offenen Fragen in der Behandlung der Lungenarterienembolie.

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