ACC/AHA guidelines surgical embolectomy: Difference between revisions
(/* ACC/AHA Guidelines- Recommendations for Catheter Embolectomy and Fragmentation (DO NOT EDIT){{cite journal| author=Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ et al.| title=Management of massive and submassive pulmonary) |
(/* ACC/AHA Guidelines- Recommendations for Catheter Embolectomy and Fragmentation (DO NOT EDIT){{cite journal| author=Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ et al.| title=Management of massive and submassive pulmonary) |
||
| Line 21: | Line 21: | ||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]=== | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]=== | ||
'''4.'''Either catheter embolectomy or surgical embolectomy may be considered for patients with submassive acute PE judged to have clinical evidence of adverse prognosis (new hemodynamic instability, worsening respiratory failure, severe RV dysfunction, or major myocardial necrosis) ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])}}''. | '''4.'''Either catheter embolectomy or surgical embolectomy may be considered for patients with submassive acute PE judged to have clinical evidence of adverse prognosis (new hemodynamic instability, worsening respiratory failure, severe RV dysfunction, or major myocardial necrosis) ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''. | ||
===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]]=== | |||
'''5.'''Catheter embolectomy and surgical thrombectomy are not recommended for patients with low-risk PE or submassive acute PE with minor RV dysfunction, minor myocardial necrosis, and no clinical worsening ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])}}''. | |||
==Guidelines Resources== | ==Guidelines Resources== | ||
Revision as of 18:45, 31 October 2011
|
Pulmonary Embolism Microchapters |
|
Diagnosis |
|---|
|
Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
|
Treatment |
|
Follow-Up |
|
Special Scenario |
|
Trials |
|
Case Studies |
|
ACC/AHA guidelines surgical embolectomy On the Web |
|
Directions to Hospitals Treating ACC/AHA guidelines surgical embolectomy |
|
Risk calculators and risk factors for ACC/AHA guidelines surgical embolectomy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Synonyms and keywords: PE
Overview
Emergency surgical embolectomy with cardiopulmonary bypass is an effective treatment strategy for
- Massive PE patients
- Submassive PE with RV dysfunction when contraindications preclude thrombolysis.
- Acute PE patients who require surgical excision of a right atrial thrombus or paradoxical embolism.
ACC/AHA Guidelines- Recommendations for Catheter Embolectomy and Fragmentation (DO NOT EDIT)[1]
| “ |
Class IIa1.Depending on local expertise, either catheter embolectomy and fragmentation or surgical embolectomy is reasonable for patients with massive PE and contraindications to fibrinolysis(Level of Evidence: C). 2.Catheter embolectomy and fragmentation or surgical embolectomy is reasonable for patients with massive PE who remain unstable after receiving fibrinolysis (Level of Evidence: C). 3.For patients with massive PE who cannot receive fibrinolysis or who remain unstable after fibrinolysis, it is reasonable to consider transfer to an institution experienced in either catheter embolectomy or surgical embolectomy if these procedures are not available locally and safe transfer can be achieved (Level of Evidence: C). Class IIb4.Either catheter embolectomy or surgical embolectomy may be considered for patients with submassive acute PE judged to have clinical evidence of adverse prognosis (new hemodynamic instability, worsening respiratory failure, severe RV dysfunction, or major myocardial necrosis) (Level of Evidence: C). Class III5.Catheter embolectomy and surgical thrombectomy are not recommended for patients with low-risk PE or submassive acute PE with minor RV dysfunction, minor myocardial necrosis, and no clinical worsening (Level of Evidence: C) |
” |
.
Guidelines Resources
- Guidelines on the management of Pulmonary embolism: Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension[1]
References
- ↑ 1.0 1.1 Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ; et al. (2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association". Circulation. 123 (16): 1788–830. doi:10.1161/CIR.0b013e318214914f. PMID 21422387.