ABSTRACT
The morbidity of acute pulmonary pulmonary embolism (PE) is significant, and this diagnosis confers a 15% 28-day mortality rate. The preferred approach for the treatment of submassive PE with thrombolysis and/or the application of catheter-based treatment remains intensely debated. The hemodynamic response to acute PE will vary for each patient based on several factors. Thus, a smaller PE may result in cardiovascular collapse in a patient with existing cardiopulmonary disease. In addition, patients with submassive PE who are thought to be at risk for adverse prognosis may be considered for thrombolysis. Surgical pulmonary embolectomy (SPE) remains a viable and effective means of treating massive acute PE, as well as submassive acute PE with adverse prognosis, when thrombolysis is contraindicated. SPE was reserved for massive PE with hemo-dynamic instability and when standard treatment had failed, or thrombolytics were contraindicated, as a last-line effort. SPE remains a viable and potentially critical component of comprehensive care in acute PE.
