RESUMEN

La tromboembolia pulmonar es una enfermedad común y una de las principales causas de muerte. El tromboembolismo pulmonar masivo requiere un abordaje e intervención terapéutica agresivos y oportunos. La tromboembolia pulmonar aguda asociada a inestabilidad hemodinámica (choque o hipotensión arterial) tiene un riesgo alto de mortalidad (25-65%) en las primeras horas, y hasta el 10% de riesgo de progresar a choque cardiogénico; se estima que hasta en el 50% de los casos esta se asocia a tromboembolia pulmonar recurrente. El tratamiento que con base en la evidencia ha demostrado mejoría clínica y disminución en el riesgo de mortalidad es la anticoagulación. Sin embargo, existen condiciones clínicas en las que el inicio de esta terapia puede estar contraindicado; es decir, deberán considerarse otras opciones terapéuticas. Al presente, no existe evidencia concreta en base a estudios clínicos, de la utilidad de las opciones alternas que sean comparables con la anticoagulación, en el tratamiento de la tromboembolia pulmonar; se discuten las distintas opciones disponibles en tromboembolia pulmonar aguda.

PALABRAS CLAVE

Tromboembolismo pulmonar, circulación pulmonar, embolismo pulmonar masivo, terapia asistida por catéter, terapia endovascular.

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