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Int J Angiol
DOI: 10.1055/s-0044-1782603
Review Article

A Brief Historical Perspective on Pulmonary Embolism

Clinton T. Morgan
1   Division of Cardiothoracic Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky
,
Sibu P. Saha
1   Division of Cardiothoracic Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky
› Author Affiliations Funding None.
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Abstract

Pulmonary embolism is a major cause of mortality worldwide. In this historical perspective, we aim to provide an overview of the rich medical history surrounding pulmonary embolism. We highlight Virchow's first steps toward understanding the pathophysiology in the 1800s. We see how those insights inspired early attempts at intervention such as surgical pulmonary embolectomy and caval ligation. Those early interventions were refined and ultimately led to the development of inferior vena cava filters, the earliest clinical applications of anticoagulation, and even apparently disparate medical advances such as the successful development of cardiopulmonary bypass. We also see how the diagnosis of pulmonary embolism has evolved from rudimentary monitoring of vitals and symptoms to the development of evermore sophisticated tests such as contrast tomography angiography and echocardiography. Finally, we discuss current approaches to diagnosis, classification, and myriad treatments including anticoagulation, thrombolysis, catheter-directed interventions, surgical embolectomy, and extracorporeal membrane oxygenation guided by Pulmonary Embolism Response Teams.

Keywords

pulmonary embolism - Pulmonary Embolism Response Teams - extracorporeal membrane oxygenation - embolectomy


Publication History

Article published online:
05 April 2024

© 2024. International College of Angiology. This article is published by Thieme.

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  • References

  • 1 Laennec RTH. De l'auscultation medicale. Paris:: Brossen et Claude;; 1819
    Google Scholar
  • 2 Cruveilhier J. Anatomic pathologique du corps humain. Paris:: JB Baillere;; 1829
    Google Scholar
  • 3 Virchow R. Die Cellularpathologic in Ihrer Begrudung auf Physiologisch und Pathologische Gewebelehre. Berlin:: A. Hirschwald;; 1858
    Google Scholar
  • 4 Trendelenburg F. Ueber die operative Behandlung der Embolie der Lungenarterie. Arch Klin Chir 1908; 86 (03) 686-700
    PubMedGoogle Scholar
  • 5 Kirschner MB. Ein durch die Trendelenburgsche Operation geheilter Fall von Embolie der Art. pulmonalis. Arch Klin Chir 1924; 133: 312-359
    PubMedGoogle Scholar
  • 6 Saeed G, Gradaus R, Neuzner J. Historical remarks on the original trendelenburg operation for massive pulmonary embolism. Tex Heart Inst J 2013; 40 (05) 633-634
    PubMedGoogle Scholar
  • 7 McFadden PM, Ochsner JL. A history of the diagnosis and treatment of venous thrombosis and pulmonary embolism. Ochsner J 2002; Winter; 4 (01) 9-13
    PubMedGoogle Scholar
  • 8 Stoney WS. Evolution of cardiopulmonary bypass. Circulation 2009; 119 (21) 2844-2853
    CrossrefPubMedGoogle Scholar
  • 9 Sharp EH. Pulmonary embolectomy: successful removal of a massive pulmonary embolus with the support of cardiopulmonary bypass. Case report. Ann Surg 1962; 156 (01) 1-4
    CrossrefPubMedGoogle Scholar
  • 10 Meyer G, Tamisier D, Sors H. et al. Pulmonary embolectomy: a 20-year experience at one center. Ann Thorac Surg 1991; 51 (02) 232-236
    CrossrefPubMedGoogle Scholar
  • 11 Aklog L, Williams CS, Byrne JG, Goldhaber SZ. Acute pulmonary embolectomy: a contemporary approach. Circulation 2002; 105 (12) 1416-1419
    CrossrefPubMedGoogle Scholar
  • 12 Fukuda I, Taniguchi S, Fukui K, Minakawa M, Daitoku K, Suzuki Y. Improved outcome of surgical pulmonary embolectomy by aggressive intervention for critically ill patients. Ann Thorac Surg 2011; 91 (03) 728-732
    CrossrefPubMedGoogle Scholar
  • 13 Pickering JW, Hewitt JA. Studies of the coagulation of the blood: part II. Thrombin and antithrombins. Biochem J 1922; 16 (05) 587-598
    CrossrefPubMedGoogle Scholar
  • 14 Hemker HC. A century of heparin: past, present and future. J Thromb Haemost 2016; 14 (12) 2329-2338
    CrossrefPubMedGoogle Scholar
  • 15 Barritt DW, Jordan SC. Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial. Lancet 1960; 1 (7138) 1309-1312
    CrossrefPubMedGoogle Scholar
  • 16 Pennica D, Holmes WE, Kohr WJ. et al. Cloning and expression of human tissue-type plasminogen activator cDNA in E. coli. Nature 1983; 301 (5897) 214-221
    CrossrefPubMedGoogle Scholar
  • 17 Lim GB. Milestone 2: Warfarin: from rat poison to clinical use. Nat Rev Cardiol 2017. Epub ahead of print.
    PubMedGoogle Scholar
  • 18 DeWeese MS, Hunter DC. A vena caval filter for the prevention of pulmonary embolism. Arch Surg 1963; 86: 852-866
    CrossrefPubMedGoogle Scholar
  • 19 Homans J. Thrombosis of deep veins of the lower leg, causing pulmonary embolism. N Engl J Med 1934; 211: 993-997
    CrossrefPubMedGoogle Scholar
  • 20 Homans J. Deep quiet venous thrombosis in lower limb; preferred levels for interruption of veins; iliac sector or ligation. Surg Gynecol Obstet 1944; 79: 7027
    PubMedGoogle Scholar
  • 21 Dale WA. Ligation of the inferior vena cava for thromboembolism. Surgery 1958; 43 (01) 24-44
    PubMedGoogle Scholar
  • 22 O'Neil EE. Ligation of the inferior vena cava in the prevention and treatment of pulmonary embolism. N Engl J Med 1945; 232: 643-646
    CrossrefPubMedGoogle Scholar
  • 23 Kirtley Jr JA, Riddell DH, Hamilton EC. Indications and late results of ligation of inferior vena cava. Ann Surg 1955; 141 (05) 653-663
    CrossrefPubMedGoogle Scholar
  • 24 Williams RW, Schenk Jr WG. A removable intracaval filter for prevention of pulmonary embolism: early experience with the use of the Eichelter catheter in patients. Surgery 1970; 68 (06) 999-1008
    PubMedGoogle Scholar
  • 25 Parrish EH, Adams JT, Pories WJ, Burget DE, DeWeese JA. Pulmonary emboli following vena caval ligation. Arch Surg 1968; 97 (06) 899-909
    CrossrefPubMedGoogle Scholar
  • 26 Spencer FC, Quattlebaum JK, Quattlebaum Jr JK, Sharp EH, Jude JR. Plication of the inferior vena cava for pulmonary embolism: a report of 20 cases. Ann Surg 1962; 155 (06) 827-837
    CrossrefPubMedGoogle Scholar
  • 27 Lagattolla NR, Burnand KG, Ferrar D. Vena caval interruption in the prevention of pulmonary embolism. Cardiovasc Surg 1996; 4 (04) 438-440
    PubMedGoogle Scholar
  • 28 Mobin-Uddin K, Smith PE, Martines LD, Lombardo CR, Jude JR. A vena cava filter for the prevention of pulmonary embolus. Sug Forum 1967; 18: 209
    PubMedGoogle Scholar
  • 29 Greenfield LJ, McCurdy JR, Brown PP, Elkins RC. A new intracaval filter permitting continued flow and resolution of emboli. Surgery 1973; 73 (04) 599-606
    PubMedGoogle Scholar
  • 30 Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis 1975; 17 (04) 259-270
    CrossrefPubMedGoogle Scholar
  • 31 Whitaker AN, Elms MJ, Masci PP. et al. Measurement of cross linked fibrin derivatives in plasma: an immunoassay using monoclonal antibodies. J Clin Pathol 1984; 37 (08) 882-887
    CrossrefPubMedGoogle Scholar
  • 32 Wilson III JE, Frenkel EP, Pierce AK. et al. Spontaneous fibrinolysis in pulmonary embolism. J Clin Invest 1971; 50 (03) 474-480
    CrossrefPubMedGoogle Scholar
  • 33 Dalen JE, Brooks HL, Johnson LW, Meister SG, Szucs Jr MM, Dexter L. Pulmonary angiography in acute pulmonary embolism: indications, techniques, and results in 367 patients. Am Heart J 1971; 81 (02) 175-185
    CrossrefPubMedGoogle Scholar
  • 34 Westermark N. On the roentgen diagnosis of lung embolism: brief review of the incidence, pathology and clinical symptoms of lung embolism. Acta Radiol 1938; •••: 357-372
    PubMedGoogle Scholar
  • 35 Robb GP, Steinberg I. Visualization of the chambers of the heart, the pulmonary circulation, and the great vessels in man. Am J Roentogend Radium Ther 1939; 41: 1-17
    PubMedGoogle Scholar
  • 36 Aitchison JD, McKay JM. Pulmonary artery occlusion demonstrated by angiography. Br J Radiol 1956; 29 (343) 398-399
    CrossrefPubMedGoogle Scholar
  • 37 Dalen JE, Dexter L. Pulmonary embolism. JAMA 1969; 207 (08) 1505-1507
    CrossrefPubMedGoogle Scholar
  • 38 Goodman LR, Curtin JJ, Mewissen MW. et al. Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography. AJR Am J Roentgenol 1995; 164 (06) 1369-1374
    CrossrefPubMedGoogle Scholar
  • 39 Stein PD, Fowler SE, Goodman LR. et al; PIOPED II Investigators. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006; 354 (22) 2317-2327
    CrossrefPubMedGoogle Scholar
  • 40 Fraser AG, Monaghan MJ, van der Steen AFW, Sutherland GR. A concise history of echocardiography: timeline, pioneers, and landmark publications. Eur Heart J Cardiovasc Imaging 2022; 23 (09) 1130-1143
    CrossrefPubMedGoogle Scholar
  • 41 Ludwig GD. The velocity of sound through tissues and the acoustic impedance of tissues. J Acoust Soc Am 1950; 22 (06) 862-863
    CrossrefPubMedGoogle Scholar
  • 42 Wells PN. Milestones in cardiac ultrasound: echoes from the past. History of cardiac ultrasound. Int J Card Imaging 1993; 9 (Suppl. 02) 3-9
    CrossrefPubMedGoogle Scholar
  • 43 Jaff MR, McMurtry MS, Archer SL. et al; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, American Heart Association Council on Peripheral Vascular Disease, American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular Biology. 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 2011; 123 (16) 1788-1830
    CrossrefPubMedGoogle Scholar
  • 44 Konstantinides SV. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2014; 35 (45) 3145-3146
    PubMedGoogle Scholar
  • 45 Giri J, Sista AK, Weinberg I. 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. Circulation 2019; 140 (20) e774-e801
    CrossrefPubMedGoogle Scholar
  • 46 Jiménez D, Kopecna D, Tapson V. et al; On Behalf Of The Protect Investigators. Derivation and validation of multimarker prognostication for normotensive patients with acute symptomatic pulmonary embolism. Am J Respir Crit Care Med 2014; 189 (06) 718-726
    CrossrefPubMedGoogle Scholar
  • 47 Assouline B, Assouline-Reinmann M, Giraud R. et al. Management of high-risk pulmonary embolism: what is the place of extracorporeal membrane oxygenation?. J Clin Med 2022; 11 (16) 4734
    CrossrefPubMedGoogle Scholar
  • 48 Rosovsky R, Zhao K, Sista A, Rivera-Lebron B, Kabrhel C. Pulmonary embolism response teams: purpose, evidence for efficacy, and future research directions. Res Pract Thromb Haemost 2019; 3 (03) 315-330
    CrossrefPubMedGoogle Scholar