Current Treatment of Pulmonary Embolism

Yıl 2016, Cilt: 25 Sayı: 3, 433 - 455, 30.09.2016

Abdullah Tekin

https://doi.org/10.17827/aktd.248425

Öz

Pulmonary embolism remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. The recommended definitive treatment for patients with high risk pulmonary embolism is thrombolysis. For patients with a contraindication to anticoagulation and thrombolytic therapy, surgical embolectomy and catheter-based therapies are options. In patients with intermediate-high risk pulmonary embolism, initiation of parenteral anticoagulation is recommended withour delay and thrombolytic therapy should only be given in case of hemodynamic worsening. Finally, direct oral anticoagulants have been shown to be as effective as and safer than the combination of low molecular weight heparin and vitamin K antagonist(s) in patients with low- to intermediate-risk pulmonary embolism.

Anahtar Kelimeler

Pulmonary embolism, thrombolysis, anticoagulation

Pulmoner Embolinin Güncel Tedavisi

Öz

Pulmoner emboli küresel hastalık yüküne önemli bir katkıda bulunmaktadır. Risk uyumlu tedavi ve takip olumlu sonuçlar doğurmaktadır. Yüksek riskli pulmoner emboli hastasında tavsiye edilen kesin tedavi trombolizdir. Antikoagülasyon ve trombolitik tedaviye kontraendikasyonu olan hastalarda cerrahi embolektomi ve kateter aracılı tedaviler diğer şeçenektir. Orta-yüksek riskli pulmoner embolide parenteral antikoagülasyon gecikmeden başlanmalı ve hemodinamik kötüleşme olduğu takdirde trombolitik tedavi verilmelidir. Son olarak, düşük-orta riskli pulmoner embolide direkt oral antikoagülanların, düşük molekül ağırlıklı heparin ve K vitamini antagonisti kombinasyonu kadar etkin ve daha güvenli olduğu gösterilmiştir.

Anahtar Kelimeler

Pulmoner emboli, tromboliz, antikoagülasyon

Kaynakça

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• Correspondence Address / Yazışma Adresi Abdullah Tekin
• Başkent Üniversitesi Tıp Fakültesi
• Kardiyoloji Anabilim Dalı, Ankara, Turkey
• e-mail: [e-mail]
• Geliş tarihi/ Received: 03.04.2016
• Kabul tarihi/Accepted: 12.05.2016