Modern strategy for diagnosis and treatment of pulmonary embolism

Various techniques are available for the diagnosis of pulmonary embolism (P E), including pulmonary angiography, perfusion-ventilation lung scanning, D -dimer measurement, venous ultrasonography and, most recently, helical comp uterized tomography of the chest, The advantages and disadvantages of these techniques, used alone or in combination, are briefly discussed. Studies h ave indicated that treatment with low-molecular-weight heparin (LMWH), as w ell as being more convenient to administer, is as safe and effective as sta ndard heparin therapy in acute PE. However, the efficacy and safety of LMWH in patients with acute PE and haemodynamic instability requires verificati on. Finally, the indications of inferior vena caval filters and thrombolyti c therapy are outlined. Copyright (C) 1999 S. Karger AG, Baser.