Pulmonary embolism (PE) is commonly treated primarily with pharmacological therapy, while advanced reperfusion therapies (transcatheter or surgical) are considered only in cases of contraindications or failure of standard therapies. Treatment algorithms vary depending on the patient's risk, with patients at intermediate or high risk potentially requiring evaluation for such advanced reperfusion therapies. Critical scenarios, such as contraindications to systemic thrombolysis or failure of pharmacological protocols, necessitate the activation of a multidisciplinary pulmonary embolism response team (PERT) and prompt therapeutic escalation. Integrated in-hospital pathways and the extension of PERT at the provincial/regional level are recommended to improve access to advanced therapies and promote uniform management of PE. Larger randomized clinical trials are needed to assess the efficacy of transcatheter therapies compared to current standards. In conclusion, a multidisciplinary and standardized approach, supported by evidence-based guidelines, is essential to optimize PE management and improve clinical outcomes. The Italian Society of Interventional Cardiology (SICI-GISE) aims to promote such standardization nationally with this expert position paper, ensuring appropriateness and equity of care for patients, as well as fostering further scientific research and education.
L’embolia polmonare (EP) acuta può manifestarsi con un’ampia varietà clinica in termini di gravità e potenziali complicanze. Nonostante i progressi nella sua gestione, rimane spesso sottodiagnosticata e sottotrattata. Negli ultimi anni sono state introdotte nuove opzioni terapeutiche e le evidenze scientifiche sono in continua evoluzione. Questo position paper societario si propone di fornire algoritmi pratici basati sulle evidenze attuali per una gestione tempestiva, aggiornata e standardizzata dell’EP. L’obiettivo è ottimizzare i percorsi di diagnosi e cura, migliorando così l’outcome dei pazienti affetti da questa patologia critica.
Fraccaro, C., Iannaccone, M., Boccuzzi, G.G., Boscolo Bozza, A., Carrafiello, G., Dell'Amore, A., et al. (2024). Italian Society of Interventional Cardiology (SICI-GISE) Position paper: Integrated management and transcatheter interventions for acute pulmonary embolism. GIORNALE ITALIANO DI CARDIOLOGIA, 25(11), 5-23 [10.1714/4371.43683].
Italian Society of Interventional Cardiology (SICI-GISE) Position paper: Integrated management and transcatheter interventions for acute pulmonary embolism
Martin Suarez S.;Saia F.
2024
Abstract
Pulmonary embolism (PE) is commonly treated primarily with pharmacological therapy, while advanced reperfusion therapies (transcatheter or surgical) are considered only in cases of contraindications or failure of standard therapies. Treatment algorithms vary depending on the patient's risk, with patients at intermediate or high risk potentially requiring evaluation for such advanced reperfusion therapies. Critical scenarios, such as contraindications to systemic thrombolysis or failure of pharmacological protocols, necessitate the activation of a multidisciplinary pulmonary embolism response team (PERT) and prompt therapeutic escalation. Integrated in-hospital pathways and the extension of PERT at the provincial/regional level are recommended to improve access to advanced therapies and promote uniform management of PE. Larger randomized clinical trials are needed to assess the efficacy of transcatheter therapies compared to current standards. In conclusion, a multidisciplinary and standardized approach, supported by evidence-based guidelines, is essential to optimize PE management and improve clinical outcomes. The Italian Society of Interventional Cardiology (SICI-GISE) aims to promote such standardization nationally with this expert position paper, ensuring appropriateness and equity of care for patients, as well as fostering further scientific research and education.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
