Martinez Licha, Carlos R.McCurdy, Chelsea M.Maldonado, Sarina MassoLee, Lawrence S.2020-06-262020-06-262020Martinez Licha, C. R., McCurdy, C. M., Maldonado, S. M., & Lee, L. S. (2020). Current Management of Acute Pulmonary Embolism. Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia, 26(2), 65–71. https://doi.org/10.5761/atcs.ra.19-00158https://hdl.handle.net/1805/23109Purpose: Acute pulmonary embolism (PE) remains a significant cause of morbidity and requires prompt diagnosis and management. While non-surgical approaches have supplanted surgery as primary treatment, surgical pulmonary embolectomy (SPE) remains a vital option for select patients. We review the current management of acute PE, with a focus on surgical therapy. Methods: A PubMed search was performed to identify literature regarding PE and treatment. Results were filtered to include the most comprehensive publications over the past decade. Results: PE is stratified based on presenting hemodynamic status or degree of mechanical pulmonary arterial occlusion. Although systemic or catheter-guided fibrinolysis is the preferred first-line treatment for the majority of cases, patients who are not candidates should be considered for SPE. Studies demonstrate no mortality benefit of thrombolysis over surgery. Systemic anticoagulation is a mainstay of treatment regardless of intervention approach. Following surgical embolectomy, direct oral anticoagulants (DOACs) have been shown to reduce recurrence of thromboembolism. Conclusions: Acute PE presents with varying degrees of clinical stability. Patients should be evaluated in the context of various available treatment options including medical, catheter-based, and surgical interventions. SPE is a safe and appropriate treatment option for appropriate patients.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalPulmonary embolismFibrinolysisCatheter thrombolysisSurgical pulmonary embolectomyArticle