Extract
Patients with high-risk pulmonary embolism (PE) presenting with cardiogenic shock refractory to supportive measures have a high mortality [1, 2]. Therapeutic success depends on rapid haemodynamic stabilisation and restoration of pulmonary blood flow. Thrombolytic therapy is the most widely used recanalisation strategy, but this treatment has substantial drawbacks including a high rate of bleeding complications and limited efficacy in patients with large embolic burden or in patients with recurrent PE presenting with acute-on-chronic events [3–8].
Abstract
A treatment protocol for patients with high-risk pulmonary embolism, which avoids thrombolysis and establishes rapid haemodynamic stabilisation via v-a ECMO support followed by semi-elective surgical embolectomy, is associated with excellent outcomes. http://ow.ly/rGNd30nBd22
Footnotes
Conflict of interest: F. Ius has nothing to disclose.
Conflict of interest: M.M. Hoeper reports personal fees from Actelion, Bayer, GSK and Merck (lectures and consultations), outside the submitted work.
Conflict of interest: C. Fegbeutel has nothing to disclose.
Conflict of interest: C. Kühn has nothing to disclose.
Conflict of interest: K. Olsson reports personal fees from Actelion (lectures), outside the submitted work.
Conflict of interest: N. Koigeldiyev has nothing to disclose.
Conflict of interest: I. Tudorache has nothing to disclose.
Conflict of interest: G. Warnecke has nothing to disclose.
Conflict of interest: J. Optenhöfel has nothing to disclose.
Conflict of interest: J.O. Puntigam has nothing to disclose.
Conflict of interest: A. Schäfer has nothing to disclose.
Conflict of interest: B.C. Meyer has nothing to disclose.
Conflict of interest: J.B. Hinrichs has nothing to disclose.
Conflict of interest: J. Bauersachs has nothing to disclose.
Conflict of interest: A. Haverich has nothing to disclose.
Conflict of interest: S. Cebotari has nothing to disclose.
Support statement: M.M. Hoeper, C. Kühn, G. Warnecke, A. Schäfer, J. Bauersachs, A. Haverich, S. Cebotari are supported by the Deutsche Forschungsgemeinschaft, Clinical Research Group 311 (KFO 311) “Advanced cardiac and pulmonary failure: mechanical unloading and repair” (DFG; TP1). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received September 17, 2018.
- Accepted January 11, 2019.
- Copyright ©ERS 2019
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