[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-279354-105":53,"doc-detail-279354-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","submassive-pulmonary-embolism-treatment-guidelines","Submassive Pulmonary Embolism Treatment Guidelines","","Submassive pulmonary embolism management focuses on rapid assessment and anticoagulation initiation for confirmed PE or high pretest probability patients when no contraindications exist. The guidance emphasizes risk stratification using clinical variables, biomarkers, and right-ventricular dysfunction to distinguish low, intermediate, and high-risk groups, including sPESI and PESI-based approaches. It outlines major bleeding risk considerations and discusses the debated role of systemic thrombolysis, surgical options, IVC filter indications, and the evidence limitations for specific therapies such as CBT and USCDT.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/submassive-pulmonary-embolism-treatment-guidelines/279354/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/submassive-pulmonary-embolism-treatment-guidelines/279354.png","ImageObject",442,249,{"name":88,"@type":89},"Aurora","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-30","2026-09-16",true,{"@type":98,"interactionType":99,"userInteractionCount":15},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"How should confirmed PE or high pretest probability patients be treated initially?","Question",{"text":108,"@type":109},"Start anticoagulation as soon as possible unless contraindicated.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What is the purpose of risk stratification in acute pulmonary embolism?",{"text":113,"@type":109},"To classify patients into low, intermediate, or high-risk groups using required information such as clinical factors, biomarkers, and right-ventricular dysfunction.",{"name":115,"@type":106,"acceptedAnswer":116},"When should IVC filters be used?",{"text":117,"@type":109},"Use IVC filters only when anticoagulation is absolutely contraindicated.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},279354,1791375519,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":15,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":60,"faqs":136,"seo_title":137,"seo_description":61,"update_tm":138,"read_time":73},4810365810221,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","Open  \nSubmassive pulmonary embolism treatment guidelines  \nSubmassive pe treatment guidelines. How to treat massive pulmonary embolism. Dvt pe treatment guidelines. Treatment guidelines for pulmonary embolism.  \nRisk stratification for proven acute pulmonary embolism: what information is needed? Riva N, Puljak L, Moja L, Ageno W, Schünemann H, Magrini N, et al. Ultrasound waves may increase thrombus penetration of thrombolytic drugs by acoustic streaming. 50. Acad Emerg Med 2016;23: 144–150. Impact of thrombolytic therapy on the long-term outcome of intermediate-risk pulmonary embolism. 18. Definition of Pulmonary Embolism Based on Severity according to American College of Chest Physicians, American Heart Association, and European Society of Cardiology Guidelines sPESI ScoreShockRV Dysfunction or Biomarker Elevation*ACCP Low riskN/ANoNo Intermediate  \nriskN/ANoEither one present High riskN/ASBP 110 beats/min (1 points)sPESISyncope (1 .5 points)RV dysfunction (2 points)DVTTroponin I (2 points)Patients with confirmed PE or high pretest probability should be started on anticoagulation as soon as possible unless contraindicated. Ruíz-Giménez N, Suárez C, González R, Nieto JA, Todolí JA, Samperiz AL, et al.; RIETE Investigators. Major Bleeding Risk–Predicting Scores in Pulmonary Embolism TreatmentScorePercent PredictedRIETE score for major bleeding (51) (VKA-related bleeding score) Low risk (0 points)0. 3% Intermediate risk (1–4 points)2.6% High risk ( >4%)7. 3%PE-CH score for ICH (55) (systemic thrombolysis–related bleeding risk score) 01. 2% 12.9% 23.4% > 517.8%Age above 65 years and kidney disease increase the intracranial hemorrhage (ICH) risk with thrombolysis (54) . Identification of intermediate-risk patients with acute symptomatic pulmonary embolism. Elevation of biomarkers carries an independent risk of short-term mortality and RV dysfunction (24, 36) . Healthcare Cost and Utilization Project (HCUP) . RV failure can be caused by an increase in preload, an increase in afterload, or a decrease in myocardial contractility resulting from ischemia (20) . Prospective validation of the Pulmonary Embolism Severity Index: a clinical prognostic model for pulmonary embolism. Jiménez D, Aujesky D, Moores L, Gómez V, Lobo JL, Uresandi F, et al.; RIETE Investigators. The safety data for DOACs appear to derive from clinical trial settings in which the majority of patients at high bleeding risk were excluded.The role of systemic thrombolysis in submassive PE is controversial. The sPESI score uses 6 risk factors as compared with 11 risk factors in the original PESI score (28, 31) . Predictors of costs from the hospital perspective of primary pulmonary embolism. We recommend that surgical embolectomy be reserved for special situations in patients with submassive PE at expert centers. There is no evidence to suggest that USCDT is superior to standard CDT.9.IVC filters should be used only when anticoagulation is absolutely contraindicated. Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, et al. 75. Original and Simplified Pulmonary Embolism Severity IndexesParameterOriginal PESI PointssPESI PointsAgeAge in yr1 point (if aged >80 yr)Male sex+10 pointsN/AHistory of cancer+30 points1 pointHistory of chronic lung disease*+10 points1 pointHistory of heart failure*+10 pointsHR ≥110 beats/min+20 points1 pointSBP 30 breaths/min+20 pointsN/ATemperature 80 yr) (80) . The PROTECT (Prognostic Significance of Multidetector CT in Normotensive Patients with Pulmonary Embolism) multimarker index, FAST score (based on a positive heart-type fatty acid-binding protein test, syncope, and tachycardia), and Bova score predict a complicated course (e.g., all-cause mortality, need for vasopressors, mechanical ventilation, recurrent PE) in 22–29. 2% of patients with PE (46–48) (Table 3) . The incidence rates of CTEPH are around 0. 56% in all patients with PE and 3% in PE survivors at 2 years (84) . Definitions of major bleeding vary in the ","cbCaiaGA1bIMnHdd","https://ap.wps.com/l/cbCaiaGA1bIMnHdd","pdf",337348,"English","[{\"question\":\"How should confirmed PE or high pretest probability patients be treated initially?\",\"answer\":\"Start anticoagulation as soon as possible unless contraindicated.\"},{\"question\":\"What is the purpose of risk stratification in acute pulmonary embolism?\",\"answer\":\"To classify patients into low, intermediate, or high-risk groups using required information such as clinical factors, biomarkers, and right-ventricular dysfunction.\"},{\"question\":\"When should IVC filters be used?\",\"answer\":\"Use IVC filters only when anticoagulation is absolutely contraindicated.\"}]","Submassive Pulmonary Embolism Treatment Guidelines | PDF",1789519280]