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ISSUE 33

Welcome to issue 33 of PERTinent Updates, featuring a select group of articles for your review. We aim to inform and update our members with the most recent major developments in the fields of PE/VTE so that we in the PERT Consortium® can continue to be at the leading edge of improving care for this vulnerable and overlooked group of patients.

“It was a pleasure once again to highlight the year’s most impactful articles in pulmonary embolism. While such decisions are inherently subjective, it was gratifying to see the broad spectrum of care in which PERTs are involved in represented in the topics of the chosen manuscripts. This included risk stratification of hospitalized PE patients, best anticoagulation strategies for cancer-associated thrombosis, catheter-based management of acute PE, and surgical management of acute PE. Of course there are so many other important articles that arise over the course of the year in PE. We hope you stay tuned to PERTinent Updates to stay abreast of the latest research in our field.”
-Session Moderators
Jay Giri, MD
Matthew Langston, MD

Survival and Right Ventricular Function After Surgical Management of Acute Pulmonary Embolism.
Goldberg JB, Spevack DM, Ahsan S, Rochlani Y, Dutta T, Ohira S, Kai M, Spielvogel D, Lansman S, Malekan R.J Am Coll Cardiol. 2020 Aug 25;76(8):903-911. doi: 10.1016/j.jacc.2020.06.065.PMID: 32819463

From the Authors – “This study describes the safety and efficacy of a surgical treatment strategy at achieving survival and RV recovery in patients with hemodynamically significant acute pulmonary embolisms.  Our large, single center experience demonstrates that surgical embolectomy and/or ECMO achieved RV recovery and survival to discharge even among patients who presented with advanced cardiogenic shock and CPR, a population that continues to have a high mortality rate with conventional management strategies.  This publication poses the question to the PE management community:  Should embolectomy or ECMO be considered first with hemodynamically significant pulmonary embolisms?”
-Joshua Goldberg

Utilization and Outcomes of Thrombolytic Therapy for Acute Pulmonary Embolism: A Nationwide Cohort Study.
Beyer SE, Shanafelt C, Pinto DS, Weinstein JL, Aronow HD, Weinberg I, Yeh RW, Secemsky EA, Carroll BJ.
Chest. 2020 Mar;157(3):645-653. doi: 10.1016/j.chest.2019.10.049.
Epub 2019 Nov 26.PMID: 31783016

From the Authors “The strength of our analysis was in the large number of patients we were able to identify and I think our findings confirmed what many had previously thought of systemic and catheter-directed thrombolysis. However, the limitations with an administrative claims dataset emphasizes the need for prospective and hopefully randomized trials that can further evaluate the variety of thrombolytic treatment options.” -Brett Carroll

Comparison of 4 Acute Pulmonary Embolism Mortality Risk Scores in Patients Evaluated by Pulmonary Embolism Response Teams.

Barnes GD, Muzikansky A, Cameron S, Giri J, Heresi GA, Jaber W, Wood T, Todoran TM, Courtney DM, Tapson V, Kabrhel C.JAMA Netw Open. 2020 Aug 3;3(8):e2010779. doi: 10.1001/jamanetworkopen.2020.10779.PMID: 32845326

From the Authors “Our publication from the PERT pilot registry highlights the importance of integrating multiple clinical variables into risk stratification for patients with acute PE. Rather than rely on a single predictive scheme, elements from multiple risk scores/schemes and other clinical variables should be used together. Furthermore, understanding how different risk scores were developed may impact how they are used – for instance reserving sPESI for determining who is low enough risk for home treatment but not for interventional therapies.”

-Geoff Barnes

Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer.

Agnelli G, Becattini C, Meyer G, Muñoz A, Huisman MV, Connors JM, Cohen A, Bauersachs R, Brenner B, Torbicki A, Sueiro MR, Lambert C, Gussoni G, Campanini M, Fontanella A, Vescovo G, Verso M; Caravaggio Investigators.N Engl J Med. 2020 Apr 23;382(17):1599-1607. doi: 10.1056/NEJMoa1915103. Epub 2020 Mar 29.PMID: 32223112

Click for access to the video recording of this session from the 2020 PER Scientific Symposium (Friday, 4:15PM Session)