Abstract：
Thanks to advances in interventional cardiology technologies, catheter-directed treatment has become recently a viable therapeutic option in the treatment of patients with acute pulmonary embolism at high risk of early mortality. Current transcatheter techniques allow for local fibrinolysis or embolectomy with minimal risk of complications. Therefore, these procedures can be considered in high-risk patients as an alternative to surgical pulmonary embolectomy when systemic thrombolysis is contraindicated or ineffective. They are also considered in patients with intermediate-high-risk pulmonary embolism who do not improve or deteriorate clinically despite anticoagulation. The purpose of this article is to present the role of transcatheter techniques in the treatment of patients with acute pulmonary embolism. We describe current knowledge and expert opinions in this field. Interventional treatment is described in the broader context of patient care organization and therapeutic modalities. We present the organization and responsibilities of pulmonary embolism response team, role of pre-procedural imaging, periprocedural anticoagulation, patient selection, timing of intervention, and intensive care support. Currently available catheter-directed therapies are discussed in detail including standardized protocols and definitions of procedural success and failure. This expert opinion has been developed in collaboration with experts from various Polish scientific societies, which highlights the role of teamwork in caring for patients with acute pulmonary embolism.
摘要：
由于介入心脏病学技术的进步，导管导向治疗已成为近期治疗急性肺栓塞患者早期死亡风险高的可行治疗选择.当前的经导管技术允许局部纤维蛋白溶解或栓子切除术，而并发症的风险最小。因此,当全身溶栓禁忌或无效时,在高危患者中可以考虑将这些手术作为外科肺栓子切除术的替代方法.在尽管抗凝治疗但临床上没有改善或恶化的中度高危肺栓塞患者中也考虑了它们。本文的目的是介绍经导管技术在治疗急性肺栓塞患者中的作用。我们描述了该领域的当前知识和专家意见。在患者护理组织和治疗方式的更广泛背景下描述了介入治疗。我们介绍肺栓塞反应小组的组织和职责，术前成像的作用，围手术期抗凝,患者选择,干预的时机,和重症监护支持。详细讨论了当前可用的导管定向治疗，包括标准化协议以及程序成功和失败的定义。该专家意见是与波兰各科学学会的专家合作制定的，这突出了团队合作在护理急性肺栓塞患者中的作用。
