Abstract
Pulmonary embolism is a common cause of morbidity and mortality which continues to
increase in overall incidence. Because it can occur with a wide range of clinical
presentations, different guidelines have been developed for appropriate risk stratification
of patients; interventional radiology plays a vital role in the management of both
massive and submassive pulmonary embolism. Catheter-directed therapy, including mechanical
and aspiration thrombectomy, standard catheter-directed thrombolysis, and ultrasound-accelerated
thrombolysis, has many benefits, including lower thrombolytic doses and intraclot
administration of thrombolytic therapy. While the role of catheter-directed therapy
is still being developed, four important prospective studies have demonstrated its
safety and efficacy. Additional studies comparing short- and long-term clinical outcomes
in patients treated with catheter-directed therapy versus anticoagulation are the
next step in understanding its role within the management of submassive pulmonary
embolism. Furthermore, multidisciplinary pulmonary embolism response teams, in which
interventional radiology plays a crucial role, are becoming essential to appropriately
managing pulmonary embolism patients, including selection of those who may benefit
from catheter-directed therapy.
Keywords
pulmonary embolism - submassive pulmonary embolism - catheter-directed therapy - catheter-directed
thrombolysis - pulmonary embolism response team - interventional radiology
