This book is a comprehensive guide to the diagnosis and management of all stages of pulmonary embolism, starting with acute and ending with chronic thromboembolic pulmonary hypertension. Acute pulmonary embolism (PE) is responsible for 150-250,000 hospitalizations and 60-100,000 deaths each year in the United States, making it the third most common cause of cardiovascular death. Acute PE spans a wide spectrum of clinical outcomes mainly based on the right ventricle's (RV) capacity to tolerate strain. There have been many recent advances in the field of PE, including guidelines on classification and risk stratification, anticoagulation, as well as evolving areas in treatment options and follow up.
The text begins with a review of the epidemiology and risk factors for PE. Chapters then delve into reviewing the decision pathways based on PE severity and treatment options, including the use of oral anticoagulation, systemic and catheter-directed thrombolysis, mechanical and surgical thrombectomy, and hemodynamic support with extracorporeal membrane oxygenation. The text then focuses on post-PE complications such as post-PE syndrome, chronic thromboembolic disease, and chronic thromboembolic pulmonary hypertension (CTEPH).
This is an ideal guide for providers of lung health, including pulmonary and critical care physicians, cardiologists, thoracic and cardiovascular surgeons. Physician-trainees, physician assistants, nurses and respiratory therapists with interest in pulmonary disorders, cardiovascular disease, pulmonary embolism, critical care or pulmonary hypertension will also find great value in this comprehensive guide.
Belinda Rivera-Lebron, MD, MS is Associate Professor in the Department of Medicine at the University of Pittsburgh. She is also Director of the UPMC Acute Pulmonary Embolus (PE) Program and the UPMC Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program.
Gustavo A. Heresi, MD, MS is Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, as well as the Director of the Pulmonary Vascular and CTEPH Program in the Respiratory Institute at the Cleveland Clinic in Ohio.
Epidemiology of Pulmonary Embolism.- PE Diagnosis.- Risk Stratification of Acute PE.- Bleeding Risk Considerations Prior to Initiation and Duration of Anticoagulation Therapy for the Treatment of Venous Thromboembolism.- Treatment for Pulmonary Embolism: Anticoagulation Selection and Duration.- Indications for systemic thrombolysis over anticoagulation.- Endovascular techniques in the treatment of acute PE.- Role of surgical embolectomy and ECMO in PE.- Inferior Vena Cava filters in Venous Thromboembolism - Multidisciplinary PE response team (PERT) development and implementation.- Post-PE Management.- Epidemiology and Diagnosis of Chronic Thromboembolic Pulmonary Hypertension.- Medical, Endovascular and Surgical Treatment of CTEPH