急性肺栓塞介入治疗技术与器械研发进展OA

Acute pulmonary embolism(APE)is one of the most severe forms of venous thromboembolism and is characterized by abrupt onset,rapid progression,and high mortality.Reperfusion therapy is a key strategy for improving outcomes in patients with high-risk and selected intermediate-high-risk APE.Although systemic thrombolysis can rapidly restore pulmonary perfusion and reduce right ventricular overload,its clinical use is limited by a substantial risk of bleeding and multiple contraindications.In recent years,with the refinement of risk stratification strategies,the establishment of pulmonary embolism response teams,advances in catheter-based interventions,and the rapid development of dedicated devices,catheter-directed therapy has attracted increasing attention and has gradually evolved from a rescue treatment into an important risk-stratified therapeutic option.Current interventional approaches for APE mainly include catheter-directed thrombolysis,pigtail catheter thrombus fragmentation,manual aspiration thrombectomy,and percutaneous mechanical thrombectomy,among which mechanical thrombectomy has developed most rapidly.Several imported systems,including Indigo,FlowTriever,and AlphaVac,as well as domestically developed devices such as Tendvia,have been introduced into clinical practice.Available evidence suggests that these techniques can rapidly reduce thrombus burden,improve right ventricular function,and stabilize hemodynamics while minimizing or avoiding the use of thrombolytic agents.This article reviews current guideline recommendations,technological advances,device development and clinical applications of interventional therapy for APE,discusses its use in special clinical scenarios and existing challenges,and highlights future directions for research and clinical practice.