Venous Interventions

Session: Educational Exhibit Presentations - Station 11: Venous Interventions

Contemporary Management of Pulmonary Embolism: What We Know (And a lot of what we don’t)

Monday, March 6, 2023

5:20 PM – 5:25 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

RM

Rajat Mohanka, n/a

Medical Student
NYIT College of Osteopathic Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

QJ

Qasim Javed, M.D.

Resident Physician
NYU School of Medicine
David Swilling, BS

Research Intern
NYU Grossman School of Medicine
MB

Matthew Bellesheim, n/a

Medical Student
Ross University School of Medicine
JS

Jay H. Shah, MD

Assistant Professor
Emory University School of Medicine
C. Matthew Hawkins, MD

Associate Professor of Radiology
Emory University School of Medicine
AG

Anne Gill, MD

Associate Professor
Children's Healthcare of Atlanta
DV

Darshan Variyam, MD

Interventional Radiologist
Boston Children's Hospital - Dept of Radiology/IR
Bedros Taslakian, MD, EBIR

Director of VIR Research Program; Director of Clinical Research Integration
NYU Grossman School of Medicine Program
John Fritz Angle, MD

Professor
University of Virginia Health System
Luke R. Wilkins, MD, FSIR

Associate Professor
University of Virginia
Frederic Bertino, MD

Clinical Assistant Professor; Director of Pediatric Interventional Radiology
Department of Radiology at NYU Grossman School of Medicine

Disclosure(s):

Rajat Mohanka, n/a: No financial relationships to disclose

David Swilling, BS: No financial relationships to disclose

Jay H. Shah, MD: No relevant disclosure to display

C. Matthew Hawkins, MD: Guerbet LLC: Consultant (Terminated, November 30, 2022)

Anne Gill, MD: No financial relationships to disclose

Bedros Taslakian, MD, EBIR: Advarra: Consultant (Ongoing), Independent Contractor (Ongoing); Atheneum: Consultant (Ongoing); Elsevier: Royalties (Ongoing); Guidepoint: Consultant (Ongoing); Siemens: Contracted Research (Ongoing); Varian Medical Systems: Contracted Research (Ongoing)

John Fritz Angle, MD: No relevant disclosure to display

Luke R. Wilkins, MD, FSIR: No financial relationships to disclose

Learning Objectives:

Review the diagnosis, classifications, and medical management of PE

Review the current literature regarding the use of anticoagulation, thrombolytics and mechanical thrombectomy

Understand the pathophysiology of CTEPH and its implications for various treatment options

Appreciate the value of ongoing clinical trials and implications for future directions in the management of VTE

Background: Venous thromboembolism (VTE) manifests as deep vein thrombosis and pulmonary embolism driven by hypercoagulability, endothelial injury, or venous stasis. The advent of new percutaneous endovascular treatment modalities in the last decade has shaped how interventional radiologists risk-stratify and manage pulmonary embolism. However, the device selection and course of treatment is not yet standardized. This educational exhibit serves to provide a thorough review of the current literature in the contemporary management of VTE, assessment of new technologies, and preliminary treatment algorithms for the suggested management of VTE in adult and pediatric patients from several institutions.

Clinical Findings/Procedure Details:
At the conclusion of this educational exhibit, the reader should:

Understand the current schema of clinical risk stratification of PE.

Be familiar with the current care standard for the medical therapy of patients with PE.

Understand the spectrum of novel devices and their safety, efficacy, and limitations for percutaneous catheter directed thrombolysis and mechanical thrombectomy.

Risk-stratify patients and identify treatment modalities based on the body of literature and experience from other institutions.

Be familiar with upcoming clinical trials that will better guide the management for PE patients.

Understand how the pathophysiology of CTEPH may have a role in the chosen modality based on the presence or absence of patient risk factors

Conclusion and/or Teaching Points:
With multiple treatment options for VTE at the interventional radiologist’s disposal, a better understanding of the efficacy, safety, and indications for each therapy will aid the interventional radiologist in treating patients with PE.