Thrombolyse bei akuter Lungenembolie – Risikostratifizierung, risikoadaptierte Diagnostik und Therapie

Zusammenfassung

Die Strategien zur Risikostratifizierung und risikoadaptierten Diagnostik und Therapie von Patienten mit akuter Lungenembolie befinden sich derzeit in einer Phase des Umbruchs. Für die neuen europäischen Leitlinien, die Mitte des Jahres 2014 erscheinen sollen, werden umfangreiche Überarbeitungen unter anderem auch hinsichtlich der Indikation zur Thrombolyse bei normotensiven Patienten mit „intermediärem“ Risiko erwartet. In diesem Artikel werden die Empfehlungen zur Thrombolyse bei Patienten mit akuter Lungenembolie zusammengefasst unter besonderer Berücksichtigung aktueller Studiendaten zur thrombolytischen Therapie bei Patienten mit „intermediärem“ Risiko.

Summary

Currently strategies for risk stratification and risk-adjusted diagnostic and management algorithms of patients with acute pulmonary embolism underlie considerable progress and transition. For the new European guidelines, publication expected for mid 2014, considerable changes are expected among others regarding the indication for thrombolysis of normotensive patients with intermediate-risk. This article summarises the recommendations for thrombolysis of patients with acute pulmonary embolism with special consideration of recent findings from clinical trials regarding thrombolysis of intermediate-risk patients.

Key words

Risk stratification - thrombolysis - PEITHO - bleeding risk

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