| . | Indication . | Contraindication . | |
|---|---|---|---|
| Anticoagulation | Normotensive and normal RV function | ||
| INR target 2.5 (range 2.0–3.0) | |||
| Clinical scenario | Duration of anticoagulation | ||
| PE secondary to a reversible risk factor | 3 months, vitamin K antagonist | ||
| Unprovoked PE | ≥3 months, vitamin K antagonist | ||
| Recurrent unprovoked PE | Indefinite, vitamin K antagonist | ||
| PE and cancer | LMWH for the first 3–6 months, followed by indefinite vitamin K antagonist or LMWH therapy | ||
| Thrombolysis | Normotensive and RV dysfunction PE causing haemodynamic compromise | See Table 2 Severely compromised patients requiring emergency embolectomy | |
| Catheter embolectomy | Contraindications to thrombolytic therapy Failure of thrombolytic therapy Surgical embolectomy is unavailable | Expertise or facility unavailable | |
| Surgical embolectomy | Failed thrombolytic therapy Failed catheter embolectomy Insufficient time for effective thrombolytic therapy in critical patients | Chronic thromboembolism Active gastrointestinal/surgical site bleeding | |
| . | Indication . | Contraindication . | |
|---|---|---|---|
| Anticoagulation | Normotensive and normal RV function | ||
| INR target 2.5 (range 2.0–3.0) | |||
| Clinical scenario | Duration of anticoagulation | ||
| PE secondary to a reversible risk factor | 3 months, vitamin K antagonist | ||
| Unprovoked PE | ≥3 months, vitamin K antagonist | ||
| Recurrent unprovoked PE | Indefinite, vitamin K antagonist | ||
| PE and cancer | LMWH for the first 3–6 months, followed by indefinite vitamin K antagonist or LMWH therapy | ||
| Thrombolysis | Normotensive and RV dysfunction PE causing haemodynamic compromise | See Table 2 Severely compromised patients requiring emergency embolectomy | |
| Catheter embolectomy | Contraindications to thrombolytic therapy Failure of thrombolytic therapy Surgical embolectomy is unavailable | Expertise or facility unavailable | |
| Surgical embolectomy | Failed thrombolytic therapy Failed catheter embolectomy Insufficient time for effective thrombolytic therapy in critical patients | Chronic thromboembolism Active gastrointestinal/surgical site bleeding | |
INR: international normalized ratio.
| . | Indication . | Contraindication . | |
|---|---|---|---|
| Anticoagulation | Normotensive and normal RV function | ||
| INR target 2.5 (range 2.0–3.0) | |||
| Clinical scenario | Duration of anticoagulation | ||
| PE secondary to a reversible risk factor | 3 months, vitamin K antagonist | ||
| Unprovoked PE | ≥3 months, vitamin K antagonist | ||
| Recurrent unprovoked PE | Indefinite, vitamin K antagonist | ||
| PE and cancer | LMWH for the first 3–6 months, followed by indefinite vitamin K antagonist or LMWH therapy | ||
| Thrombolysis | Normotensive and RV dysfunction PE causing haemodynamic compromise | See Table 2 Severely compromised patients requiring emergency embolectomy | |
| Catheter embolectomy | Contraindications to thrombolytic therapy Failure of thrombolytic therapy Surgical embolectomy is unavailable | Expertise or facility unavailable | |
| Surgical embolectomy | Failed thrombolytic therapy Failed catheter embolectomy Insufficient time for effective thrombolytic therapy in critical patients | Chronic thromboembolism Active gastrointestinal/surgical site bleeding | |
| . | Indication . | Contraindication . | |
|---|---|---|---|
| Anticoagulation | Normotensive and normal RV function | ||
| INR target 2.5 (range 2.0–3.0) | |||
| Clinical scenario | Duration of anticoagulation | ||
| PE secondary to a reversible risk factor | 3 months, vitamin K antagonist | ||
| Unprovoked PE | ≥3 months, vitamin K antagonist | ||
| Recurrent unprovoked PE | Indefinite, vitamin K antagonist | ||
| PE and cancer | LMWH for the first 3–6 months, followed by indefinite vitamin K antagonist or LMWH therapy | ||
| Thrombolysis | Normotensive and RV dysfunction PE causing haemodynamic compromise | See Table 2 Severely compromised patients requiring emergency embolectomy | |
| Catheter embolectomy | Contraindications to thrombolytic therapy Failure of thrombolytic therapy Surgical embolectomy is unavailable | Expertise or facility unavailable | |
| Surgical embolectomy | Failed thrombolytic therapy Failed catheter embolectomy Insufficient time for effective thrombolytic therapy in critical patients | Chronic thromboembolism Active gastrointestinal/surgical site bleeding | |
INR: international normalized ratio.
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