Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium

Belinda Rivera-Lebron¹, Michael McDaniel², Kamran Ahrar³, Abdulah Alrifai⁴, David M Dudzinski⁵, Christina Fanola⁶, Danielle Blais⁷, David Janicke⁸, Roman Melamed⁹, Kerry Mohrien¹⁰, Elizabeth Rozycki⁷, Charles B Ross¹¹, Andrew J Klein¹¹, Parth Rali¹⁰, Nicholas R Teman¹², Leoara Yarboro¹², Eugene Ichinose¹³, Aditya M Sharma¹², Jason A Bartos⁶, Mahir Elder^{14

15}, Brent Keeling², Harold Palevsky¹⁶, Soophia Naydenov¹⁷, Parijat Sen¹⁸, Nancy Amoroso¹⁹, Josanna M Rodriguez-Lopez⁵, George A Davis²⁰, Rachel Rosovsky⁵, Kenneth Rosenfield⁵, Christopher Kabrhel⁵, James Horowitz¹⁹, Jay S Giri¹⁶, Victor Tapson²¹, Richard Channick²²; PERT Consortium

Affiliations

¹ 1 University of Pittsburgh, Pittsburgh, PA, USA.
² 2 Emory University, Atlanta, GA, USA.
³ 3 The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁴ 4 University of Miami of Palm Beach Regional Campus/JFK Hospital, Atlantis, FL, USA.
⁵ 5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁶ 6 University of Minnesota, Minneapolis, MN, USA.
⁷ 7 The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁸ 8 University of Buffalo, Buffalo, NY, USA.
⁹ 9 Abbott Northwestern Hospital, Minneapolis, MN, USA.
¹⁰ 10 Temple University, Philadelphia, PA, USA.
¹¹ 11 Piedmont Heart Institute, Atlanta, GA, USA.
¹² 12 University of Virginia, Charlottesville, VA, USA.
¹³ 13 Oklahoma Heart Institute, Tulsa, OK, USA.
¹⁴ 14 Wayne State University, Detroit, MI, USA.
¹⁵ 15 Michigan State University, East Lansing, MI, USA.
¹⁶ 16 University of Pennsylvania, Philadelphia, PA, USA.
¹⁷ 17 Saint Louis University, St. Louis, MO, USA.
¹⁸ 18 Henry Ford Hospital, Detroit, MI, USA.
¹⁹ 19 New York University, New York, NY, USA.
²⁰ 20 University of Kentucky, Lexington, KY, USA.
²¹ 21 Cedars-Sinai Medical Center, Los Angeles, CA, USA.
²² 22 University of California, Los Angeles, CA, USA.

PMID: 31185730
PMCID: PMC6714903
DOI: 10.1177/1076029619853037

Practice Guideline

Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium

Belinda Rivera-Lebron et al. Clin Appl Thromb Hemost. 2019 Jan-Dec.

. 2019 Jan-Dec:25:1076029619853037.

doi: 10.1177/1076029619853037.

Authors

Affiliations

¹ 1 University of Pittsburgh, Pittsburgh, PA, USA.
² 2 Emory University, Atlanta, GA, USA.
³ 3 The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁴ 4 University of Miami of Palm Beach Regional Campus/JFK Hospital, Atlantis, FL, USA.
⁵ 5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁶ 6 University of Minnesota, Minneapolis, MN, USA.
⁷ 7 The Ohio State University Wexner Medical Center, Columbus, OH, USA.
⁸ 8 University of Buffalo, Buffalo, NY, USA.
⁹ 9 Abbott Northwestern Hospital, Minneapolis, MN, USA.
¹⁰ 10 Temple University, Philadelphia, PA, USA.
¹¹ 11 Piedmont Heart Institute, Atlanta, GA, USA.
¹² 12 University of Virginia, Charlottesville, VA, USA.
¹³ 13 Oklahoma Heart Institute, Tulsa, OK, USA.
¹⁴ 14 Wayne State University, Detroit, MI, USA.
¹⁵ 15 Michigan State University, East Lansing, MI, USA.
¹⁶ 16 University of Pennsylvania, Philadelphia, PA, USA.
¹⁷ 17 Saint Louis University, St. Louis, MO, USA.
¹⁸ 18 Henry Ford Hospital, Detroit, MI, USA.
¹⁹ 19 New York University, New York, NY, USA.
²⁰ 20 University of Kentucky, Lexington, KY, USA.
²¹ 21 Cedars-Sinai Medical Center, Los Angeles, CA, USA.
²² 22 University of California, Los Angeles, CA, USA.

PMID: 31185730
PMCID: PMC6714903
DOI: 10.1177/1076029619853037

Abstract

Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations in recommendations by different clinical guidelines, as well as lack of robust clinical trials, make clinical decisions challenging. The Pulmonary Embolism Response Team Consortium is an international association created to advance the diagnosis, treatment, and outcomes of patients with PE. In this consensus practice document, we provide a comprehensive review of the diagnosis, treatment, and follow-up of acute PE, including both clinical data and consensus opinion to provide guidance for clinicians caring for these patients.

Keywords: acute pulmonary embolism; catheter-directed thrombolysis; chronic thromboembolic pulmonary hypertension; embolectomy; inferior vena cava filter; pulmonary embolism response team; systemic thrombolysis; venous thromboembolism.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Figure 1.**
PERT activation. PERT indicates Pulmonary Embolism Response Team.

**Figure 2.**
Pulmonary embolism diagnosis algorithm.

**Figure 3.**
Pulmonary embolism treatment algorithm.

**Figure 4.**
Pulmonary embolism follow-up algorithm.

See this image and copyright information in PMC

References

1. Blood Clots: A Serious but Preventable Medical Condition. http://www.cdc.gov/ncbddd/dvt/documents/blood-clots-fact-sheet.pdf. Updated May 4, 2016. Accessed May 6, 2016.
1. Barnes GD, Kabrhel C, Courtney DM, et al. Diversity in the pulmonary embolism response team model: an organizational survey of the national PERT consortium members. Chest. 2016;150(6):1414–1417. - PubMed
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Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium

Affiliations

Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical