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美国心脏协会科学声明:急性肺栓塞的介入治疗进展(Circulation, IF:23.054)

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Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association.

  • Giri Jay,Sista Akhilesh K,Weinberg Ido et al. Interventional Therapies for Acute Pulmonary Embolism: Current Status and Principles for the Development of Novel Evidence: A Scientific Statement From the American Heart Association.[J] .Circulation, 2019, 140: e774-e801.

Abstract 摘要

Pulmonary embolism (PE) represents the third leading cause of cardiovascular mortality. The technological landscape for management of acute intermediate- and high-risk PE is rapidly evolving. Two interventional devices using pharmacomechanical means to recanalize the pulmonary arteries have recently been cleared by the US Food and Drug Administration for marketing, and several others are in various stages of development. The purpose of this document is to clarify the current state of endovascular interventional therapy for acute PE and to provide considerations for evidence development for new devices that will define which patients with PE would derive the greatest net benefit from their use in various clinical settings. First, definitions and limitations of commonly used risk stratification tools for PE are reviewed. An adjudication of risks and benefits of available interventional therapies for PE follows. Next, considerations for optimal future evidence development in this field are presented in the context of the current US regulatory framework. Finally, the document concludes with a discussion of the pros and cons of the rapidly expanding PE response team model of care delivery.

肺栓塞(PE)是导致心血管疾病死亡的第三大原因。急性中、高危PE处理的技术领域正在迅速发展。美国食品和药物管理局(FDA)最近批准了两种通过药物力学手段使肺动脉再通的介入装置,并将其投入市场,其他一些装置也处于不同的发展阶段。本文件的目的是阐明急性PE血管内介入治疗的现状,并为新设备的开发提供参考,以确定哪些PE患者在各种临床环境中使用可获得最大的净收益。首先,回顾了PE常用风险分层工具的定义和局限性。而后是对PE介入治疗的风险和益处的判断。接下来,在美国当前的监管框架下,提出了该领域未来最佳证据开发的考虑。最后,本文件讨论了迅速扩增的PE反应团队诊疗模式的利弊。


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