Semin intervent Radiol 2018; 35(02): 116-121
DOI: 10.1055/s-0038-1642040
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patient Assessment: Clinical Presentation, Imaging Diagnosis, Risk Stratification, and the Role of Pulmonary Embolism Response Team

Tamir Friedman
Section of Interventional Radiology, Department of Radiology, Advanced Medical Imaging, Torrington, Connecticut
,
Ronald S. Winokur
Section of Interventional Radiology, Department of Radiology, Weill Cornell/New York Presbyterian Hospital, New York, New York
,
Keith B. Quencer
Section of Interventional Radiology, Department of Radiology, University of Utah, Salt Lake City, Utah
,
David C. Madoff
Section of Interventional Radiology, Department of Radiology, Weill Cornell/New York Presbyterian Hospital, New York, New York
› Author Affiliations
Further Information

Publication History

Publication Date:
04 June 2018 (online)

Abstract

Pulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed. The evolution of treatment guidelines via various clinical trials and recommendations is outlined, setting the stage for the use of fibrinolytics, whether systemic or catheter directed. Treatment, including fibrinolytics, is predicated on patient triage into three large categories—massive, submassive, or low-risk PE. Additionally, a relatively new concept of a multidisciplinary team composed of several subspecialty experts known as the PE response team (PERT) is discussed. PERT's timely and unified recommendations have been shown to optimize care and decrease mortality while tailoring treatment to each individual afflicted by PE.