Recent Advances in the Diagnosis and Management of Pulmonary Embolism

Acute pulmonary embolism (PE) is a form of venous thromboembolism

(VTE) and has varied clinical manifestations with significant morbidity and mortality.

The general population's overall incidence is on the rise due to the increasing

availability of D-dimer and computed tomographic pulmonary angiography. The

incidence is higher in males than females (58 versus 48 per 100,000, respectively),

increasing with age. In the United States, PE accounts for approximately 100,000

deaths annually. Specific populations, including patients with malignancy, pregnant

females, hospitalized medical and surgical patients, or patients with total joint

replacement, or arthroplasty, are at a higher risk for PE. Patients presenting with

hemodynamic compromise due to PE need to be treated with intravenous thrombolytic

therapy unless contraindicated, followed by anticoagulation. For over six decades,

traditional anticoagulants like unfractionated heparin (UFH) are used for short-term

anticoagulation. For patients who require long-term anticoagulation, low molecular

weight heparin (LMWH) like enoxaparin and a vitamin K antagonist like warfarin are

used to achieve therapeutic anticoagulation. Options for anticoagulation have been

expanding steadily over the last decade with the introduction of the first direct oral

anticoagulant (DOAC). Since their introduction, DOACs have changed the landscape

of anticoagulation. This narrative review aims to summarize for clinicians managing

pulmonary embolism (PE) the main recent advances in patient care, including risk

stratification, current data regarding the use of thrombolytic treatment, and direct oral

anticoagulants.

Keywords: Anticoagulation, Catheter-Directed Therapy, Pulmonary Embolism, Thrombolysis.

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Frontiers in Anti-infective Agents

DOI https://doi.org/10.2174/9789815039535122050003	Print ISSN 2467-9585
Publisher Name Bentham Science Publisher	Online ISSN 2352-3239

Frontiers in Clinical Drug Research: Hematology