Vaskulárna medicína 1/2010

Today’s state of diagnostic and treatment of massive pulmonary thromboembolism

Concerning the diagnosis and treatment of massive pulmonary thromboembolism (MPTE) is serious problem in all areas of medicine. Correct diagnosis of MPTE arises from clinical picture and from objective imaging methods as angiopulmography, spiral computer tomography, perfusion lung scintigraphy, echocardiography, ECG, lung X-ray and haemodynamic tests. Treatment of MPTE may be anticoagulant, thrombolytic, surgical or by transvenous catheter pulmonary embolectomy. Thrombolytic treatment has a dominant position in the management of acute MPTE and it is indicated in 90 % of cases. Pulmonary embolectomy is indicated in MPTE with severe shock when vasopressoric and thrombolytic treatment is inefficient. A new alternative in the treatment of MPTE is transvenous catheter pulmonary embolectomy (TCPE), whereby the thromboemboli in pulmonary arteries are removed under angiographic control.

Keywords: pulmonary thromboembolism, diagnosis and treatment