Revascularization therapies in high-risk and intermediate-high-risk pulmonary embolism

Authors

  • Louis Meyblum Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Mathilde Aissaoui Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Geoffroy Pouliquen Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Jean-Charles Bijot Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Marine Bravetti Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Benjamin Poussot Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Eloi Varin Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France.
  • Charles Roux Sorbonne Université, AP-HP, Hôpital Universitaire Pitié-Salpêtrière, Service de radiologie interventionnelle, Paris, France. https://orcid.org/0000-0002-9584-3048

DOI:

https://doi.org/10.37051/mir-34-002143

Keywords:

Pulmonary embolism, Thrombectomy, Thrombolysis, Cardiogenic shock, VA-ECMO

Abstract

Acute high-risk and intermediate-high-risk pulmonary embolism are relatively uncommon causes of direct admission to intensive care units. However, due to the high risk of mortality, they require rapid and organized management. Effective anticoagulation combined with systemic thrombolysis remains the standard treatment for high-risk pulmonary embolisms, but these approaches have significant limitations due to the associated risk of hemorrhage. This article reviews the main data from the literature to explore the indications and various techniques for pulmonary artery revascularization in this context. It discusses traditional revascularization techniques, including systemic thrombolysis, surgical embolectomy, and extracorporeal membrane oxygenation (ECMO), as well as minimally invasive techniques such as in situ thrombolysis and thrombectomy, leading to a proposed management algorithm

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Published

2025-10-22

How to Cite

Meyblum, L., Aissaoui , M., Pouliquen, G., Bijot, J.-C., Bravetti, M., Poussot, B., Varin, E., & Roux, C. (2025). Revascularization therapies in high-risk and intermediate-high-risk pulmonary embolism. Médecine Intensive Réanimation, 34(3). https://doi.org/10.37051/mir-34-002143

Issue

Vol. 34 No. 3 (2025)

Section

Update

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