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Journal of Thrombosis and Thrombolysis

, Volume 46, Issue 1, pp 39–49 | Cite as

Treatment of submassive and massive pulmonary embolism: a clinical practice survey from the second annual meeting of the Pulmonary Embolism Response Team Consortium

  • Thomas M. Todoran
  • Jay Giri
  • Geoffrey D. Barnes
  • Rachel P. Rosovsky
  • Yuchiao Chang
  • Michael R. Jaff
  • Kenneth Rosenfield
  • Christopher Kabrhel
  • on behalf of the PERT Consortium
Article

Abstract

There is a paucity of robust clinical trial data to guide the treatment of acute pulmonary embolism (PE) thus the clinical guidelines rely heavily on expert opinion. Pulmonary Embolism Response Teams (PERT) have been developed to streamline the care of patients with acute PE. We conducted a survey among 100 experts in the field of PE during the second annual meeting of the PERT Consortium. Respondents were queried with respect to their demographic information, clinical practice questions and clinical vignettes. Clinical practice questions were focused questions about the risk stratification and treatment of patients with acute submassive PE, anticoagulation strategies for patients receiving thrombolysis and the use of inferior vena cava filters. Clinical vignettes were designed to assess participants’ preferred choice of treatment for a variety of commonly encountered clinical scenarios. Among physicians affiliated with a PERT, there is overall agreement with regards to the criteria used for risk classification of patients with PE and its application to patients in the provided clinical vignettes. In contrast, there is substantial variability in the treatment strategies of patients presenting with commonly encountered clinical scenarios. The results of this survey highlight the need for more clinical trial data along with accepted algorithms for treatment of acute PE. In the absence of this, PERTs can facilitate multidisciplinary discussions in order to standardize treatment and provide evidence-based therapies to patients with acute PE.

Keywords

Acute pulmonary embolism Pulmonary Embolism Response Team PERT PERT Consortium 

Abbreviations

CDT

Catheter-directed thrombolysis

PE

Pulmonary embolism

LWMH

Low molecular weight heparin

PERT

Pulmonary Embolism Response Team

RV

Right ventricular

UFH

Unfractionated heparin

Notes

Compliance with ethical standards

Conflict of interest

There is no conflict of interest for any of the authors.

Informed consent

Consent was implied based on voluntary participation in the activity.

Supplementary material

11239_2018_1659_MOESM1_ESM.docx (79 kb)
Supplementary material 1 (DOCX 79 KB)
11239_2018_1659_MOESM2_ESM.pptx (72 kb)
Supplementary material 2 (PPTX 72 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Thomas M. Todoran
    • 1
  • Jay Giri
    • 2
  • Geoffrey D. Barnes
    • 3
  • Rachel P. Rosovsky
    • 4
  • Yuchiao Chang
    • 5
  • Michael R. Jaff
    • 6
  • Kenneth Rosenfield
    • 6
  • Christopher Kabrhel
    • 7
  • on behalf of the PERT Consortium
  1. 1.Division of Cardiology, Sections of Interventional Cardiology and Vascular MedicineMedical University of South CarolinaCharlestonUSA
  2. 2.Penn Cardiovascular Outcomes, Quality and Evaluative Research CenterUniversity of Pennsylvania Perelman School of MedicinePhiladelphiaUSA
  3. 3.Frankel Cardiovascular Center and Institute for Healthcare Policy and Innovation, Department of Internal MedicineUniversity of Michigan Medical SchoolAnn ArborUSA
  4. 4.Division of Hematology and Oncology, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  5. 5.Division of General Internal Medicine, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  6. 6.Division of Cardiology, Section of Vascular Medicine, Department of Medicine, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  7. 7.Center for Vascular Emergencies, Department of Emergency Medicine, Massachusetts General HospitalHarvard Medical SchoolBostonUSA

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