kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2015-1-71-77kpccz-119Research ArticleОБЗОРЫ И РЕКОМЕНДАЦИИREVIEWS AND RECOMMENDATIONSАЛГОРИТМ ИНТЕНСИВНОГО ЛЕЧЕНИЯ ОСТРЫХ ТРОМБОЭМБОЛИЙ ЛЕГОЧНОЙ АРТЕРИИ: АКЦЕНТ НА ИНВАЗИВНОСТЬALGORITHM OF INTENSIVE CARE OF ACUTE PULMONARY EMBOLISM: EMPHASIS ON THE INVASIVENESSМалышенкоЕ. С.MalyshenkoE. S.radar-79@mail.ruПоповВ. А.PopovV. A.radar-79@mail.ruХаесБ. Л.HaesB. L.radar-79@mail.ruШукевичД. Л.ShukevichD. L.radar-79@mail.ruПлотниковГ. П.PlotnikovG. P.radar-79@mail.ruХерасковВ. Ю.HeraskovV. Yu.radar-79@mail.ruРадивилкоА. С.RadivilkoA. S.

Для корреспонденции:Радивилко Артем Сергеевич Адрес:650002, г. Кемерово, Сосновый бульвар, д. 6 Тел. 8 (3842) 64-33-94 E-mail: radar-79@mail.ru

For correspondence: Radivilko Artem Address: 6, Sosnoviy blvd.,Kemerovo, 650002,Russian Federation Tel. 8 (3842) 64-33-94 E-mail: radar-79@mail.ru

radar-79@mail.ruГригорьевЕ. В.GrigoryevE. V.radar-79@mail.ruБарбарашЛ. С.BarbarashL. S.radar-79@mail.ruНаучно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний, КемеровоРоссияResearch Institute for Complex Issues of Cardiovascular Diseases, KemerovoRussian Federation201503072015017177Copyright © Малышенко Е.С., Попов В.А., Хаес Б.Л., Шукевич Д.Л., Плотников Г.П., Херасков В.Ю., Радивилко А.С., Григорьев Е.В., Барбараш Л.С., 20152015Малышенко Е.С., Попов В.А., Хаес Б.Л., Шукевич Д.Л., Плотников Г.П., Херасков В.Ю., Радивилко А.С., Григорьев Е.В., Барбараш Л.С.Malyshenko E.S., Popov V.A., Haes B.L., Shukevich D.L., Plotnikov G.P., Heraskov V.Y., Radivilko A.S., Grigoryev E.V., Barbarash L.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/119

Острая тромбоэмболия легочной артерии – угрожающее жизни состояние, которое требует немедленного решения о выборе метода реперфузии. Cегодня в арсенале мультидисциплинарной команды имеются все виды восстановления кровообращения: тромболитическая терапия как «золотой стандарт» реперфузии, хирургическая эмболэктомия и эндоваскулярные методы лечения. У каждого из описанных методов есть свои достоинства и недостатки. Обоснованию выбора метода реперфузии посвящен данный обзор литературы.

Pulmonary embolism is a life-threatening condition that requires immediate decision on the choice of the method of reperfusion. Today in the arsenal of multidisciplinary command there are the all methods of restoring circulation: thrombolytic therapy as the gold standard of reperfusion, surgical embolectomy and endovascular therapies. Each of these methods has their advantages and disadvantages. Justification of the choice of the method of reperfusion is the aim of this literature review. 

острая тромбоэмболия легочной артериивыбор реперфузиитромболитическая терапияхирургическая эмболэктомияacute pulmonary embolismthe choice of reperfusionthrombolytic therapysurgical embolectomyReferencesСавельев В . С., Чазов Е . И ., Гусев Е . И ., Кириенко ские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология. 2010; 4 (2): 2–37. Savel’ev V. S., Chazov E. I., Gusev E. I., Kirienko A. I., Akchurin R. S., Andriyashkin V. V. i dr. Rossiyskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhneniy. Flebologiâ. (Phlebology). 2010; 4 (2): 2–37. [In Russ].Савельев В . С., Чазов Е . И ., Гусев Е . И ., Кириенко ские клинические рекомендации по диагностике, лечению и профилактике венозных тромбоэмболических осложнений. Флебология. 2010; 4 (2): 2–37. Savel’ev V. S., Chazov E. I., Gusev E. I., Kirienko A. I., Akchurin R. S., Andriyashkin V. V. i dr. Rossiyskie klinicheskie rekomendatsii po diagnostike, lecheniyu i profilaktike venoznykh tromboembolicheskikh oslozhneniy. Flebologiâ. (Phlebology). 2010; 4 (2): 2–37. [In Russ].British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax. 2003; 58: 470–483. doi:10.1136/thorax.58.6.470.British Thoracic Society Standards of Care Committee Pulmonary Embolism Guideline Development Group. British Thoracic Society guidelines for the management of suspected acute pulmonary embolism. Thorax. 2003; 58: 470–483. doi:10.1136/thorax.58.6.470.Jaff M. R., McMurtry M. S., Archer S. L., Cushman M., Goldenberg N., Goldhaber S. Z. et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. American Heart Association. Circulation. 2011; 123: 1788–1830. doi: 10.1161/CIR.0b013e318214914f.Jaff M. R., McMurtry M. S., Archer S. L., Cushman M., Goldenberg N., Goldhaber S. Z. et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. American Heart Association. Circulation. 2011; 123: 1788–1830. doi: 10.1161/CIR.0b013e318214914f.Васильцева О . Я., Ворожцова И . Н., Крестинин А . В ., Карпов Р. С. Сахарный диабет и тромбоэмболия легочной артерии. Комплексные проблемы сердечно-сосудистых за болеваний. 2012; 2: 34–38. Vasiltseva O. Y., Vorozhtsova I. N., Krestinin A. V., Karpov R. S. Diabetes and Pulmonary Artery Embolism. Complex Issues of Cardiovascular Diseases. 2012; 2: 34–38. [In Russ].Васильцева О . Я., Ворожцова И . Н., Крестинин А . В ., Карпов Р. С. Сахарный диабет и тромбоэмболия легочной артерии. Комплексные проблемы сердечно-сосудистых за болеваний. 2012; 2: 34–38. Vasiltseva O. Y., Vorozhtsova I. N., Krestinin A. V., Karpov R. S. Diabetes and Pulmonary Artery Embolism. Complex Issues of Cardiovascular Diseases. 2012; 2: 34–38. [In Russ].Konstantinides S. V., Torbick A., Agnelli G., Danchin N., Fitzmaurice D., Galiè N. et al. ESC Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2014; 35 (43): 3033–3069. doi: 10.1093/ eurheartj/ehu283.Konstantinides S. V., Torbick A., Agnelli G., Danchin N., Fitzmaurice D., Galiè N. et al. ESC Guidelines on the diagnosis and management of acute pulmonary embolism. The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur. Heart J. 2014; 35 (43): 3033–3069. doi: 10.1093/ eurheartj/ehu283.Torbicki A., Galie N., Covezzoli A., Rossi E., De Rosa M., Goldhaber S. Z. et al. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J. Am. CollCardiol. 2003; 41: 2245–2251. doi:10.1016/S0735-1097(03)00479-0.Torbicki A., Galie N., Covezzoli A., Rossi E., De Rosa M., Goldhaber S. Z. et al. Right heart thrombi in pulmonary embolism: results from the International Cooperative Pulmonary Embolism Registry. J. Am. CollCardiol. 2003; 41: 2245–2251. doi:10.1016/S0735-1097(03)00479-0.Jiménez D., Kopecna D., Tapson V., Briese B., Schreiber D., Lobo J. L. et al. Derivation and Validation of Multimarker Prognostication for Normotensive Patients with Acute Symptomatic Pulmonary Embolism. Am. J. of Respir. and Crit Care Med. 2014; 189 (6): 718–726. doi: 10.1164/rccm.201311-2040OC.Jiménez D., Kopecna D., Tapson V., Briese B., Schreiber D., Lobo J. L. et al. Derivation and Validation of Multimarker Prognostication for Normotensive Patients with Acute Symptomatic Pulmonary Embolism. Am. J. of Respir. and Crit Care Med. 2014; 189 (6): 718–726. doi: 10.1164/rccm.201311-2040OC.Sharifi M., Bay C., Skrocki L., Rahimi F., Mehdipour M.; «MOPETT» Investigators. Moderate pulmonary embolism treated with thrombolysis (from the ‘MOPETT’ Trial). Am. J. Cardiol. 2013; 111: 273–277. doi: 10.1016/j.amjcard. 2012.09.027.Sharifi M., Bay C., Skrocki L., Rahimi F., Mehdipour M.; «MOPETT» Investigators. Moderate pulmonary embolism treated with thrombolysis (from the ‘MOPETT’ Trial). Am. J. Cardiol. 2013; 111: 273–277. doi: 10.1016/j.amjcard. 2012.09.027.Bernard J., Yi E. S. Pulmonary thromboendarterectomy: a clinicopathologic study of 200 consecutive pulmonary thromboendarterectomy cases in one institution. Hum Pathol. 2007; 38 (6): 871–877. doi: http://dx.doi.org/10.1016/j. humpath.2006.11.017.Bernard J., Yi E. S. Pulmonary thromboendarterectomy: a clinicopathologic study of 200 consecutive pulmonary thromboendarterectomy cases in one institution. Hum Pathol. 2007; 38 (6): 871–877. doi: http://dx.doi.org/10.1016/j. humpath.2006.11.017.Blauwet L. A., Edwards W. D., Tazelaar H. D., McGregor C. G. Surgical pathology of pulmonary thromboendarterectomy: a study of 54 cases from 1990 to 2001. Hum Pathol. 2003; 34 (12): 1290–1298. doi: http://dx.doi. org/10.1016/j.humpath. 2003.07.003.Blauwet L. A., Edwards W. D., Tazelaar H. D., McGregor C. G. Surgical pathology of pulmonary thromboendarterectomy: a study of 54 cases from 1990 to 2001. Hum Pathol. 2003; 34 (12): 1290–1298. doi: http://dx.doi. org/10.1016/j.humpath. 2003.07.003.Fukuda I., Taniguchi S., Fukui K., Minakawa M., Daitoku K., Suzuki Y. et al. Improved outcome of surgical embolectomy by aggressive intervention for critical ill patients. Ann. Thorac. Surg. 2011; 91: 728–733. doi:10.1016/j. athoracsur.2010.10.086.Fukuda I., Taniguchi S., Fukui K., Minakawa M., Daitoku K., Suzuki Y. et al. Improved outcome of surgical embolectomy by aggressive intervention for critical ill patients. Ann. Thorac. Surg. 2011; 91: 728–733. doi:10.1016/j. athoracsur.2010.10.086.Greelish J. P., Leacche M., Solenkova N. S., Ahmad R. M., Byrne J. G. Improved midterm outcomes for type A (central) pulmonary emboli treated surgically. J. Thorac. Cardiovasc. Surg. 2011; 142: 1423–1429. doi: 10.1016/j. jtcvs.2010.12.030.Greelish J. P., Leacche M., Solenkova N. S., Ahmad R. M., Byrne J. G. Improved midterm outcomes for type A (central) pulmonary emboli treated surgically. J. Thorac. Cardiovasc. Surg. 2011; 142: 1423–1429. doi: 10.1016/j. jtcvs.2010.12.030.Howard L. S. Thrombolytic therapy for submassive pulmonary embolus? PRO viewpoint. Thorax. 2014; 69 (2): 103–105. doi: 10.1136/thoraxjnl-2013-203413.Howard L. S. Thrombolytic therapy for submassive pulmonary embolus? PRO viewpoint. Thorax. 2014; 69 (2): 103–105. doi: 10.1136/thoraxjnl-2013-203413.Simpson A. J. Thrombolytic therapy for submassive PE? CON viewpoint. Thorax. 2014; 69: 105–107. doi:10.1136/ thoraxjnl-2013-204193.Simpson A. J. Thrombolytic therapy for submassive PE? CON viewpoint. Thorax. 2014; 69: 105–107. doi:10.1136/ thoraxjnl-2013-204193.Aymard T., Kadner A., Widmer A., Basciani R., Tevaearai H., Weber A. et al. Massive pulmonary embolism: surgical embolectomy versus thrombolytic therapy-should surgical indications be revisited? Eur. J. Cardiothorac. Surg. 2013; 43: 90–94.doi: 10.1093/ejcts/ezs123.Aymard T., Kadner A., Widmer A., Basciani R., Tevaearai H., Weber A. et al. Massive pulmonary embolism: surgical embolectomy versus thrombolytic therapy-should surgical indications be revisited? Eur. J. Cardiothorac. Surg. 2013; 43: 90–94.doi: 10.1093/ejcts/ezs123.Hamilton-Craig C. R., McNeil K., Dunning J., Walters D. L., Slaughter R., Kermeen F. Treatment options and strategies for acute severe pulmonary embolism. Int. Med. J. 2008; 38: 657–667. doi: 10.1111/j.1445-5994.2008.01671.x.Hamilton-Craig C. R., McNeil K., Dunning J., Walters D. L., Slaughter R., Kermeen F. Treatment options and strategies for acute severe pulmonary embolism. Int. Med. J. 2008; 38: 657–667. doi: 10.1111/j.1445-5994.2008.01671.x.Kadner A., Schmidli J., Schonhoff F., Krähenbühl E., Immer F., Carrel T. et al. Excellent outcome after surgical treatment of massive pulmonary embolism in critically ill patients. J. Thorac. Cardiovasc. Surg. 2008; 136: 448–451. doi: 10.1016/j.jtcvs.2007.11.021.Kadner A., Schmidli J., Schonhoff F., Krähenbühl E., Immer F., Carrel T. et al. Excellent outcome after surgical treatment of massive pulmonary embolism in critically ill patients. J. Thorac. Cardiovasc. Surg. 2008; 136: 448–451. doi: 10.1016/j.jtcvs.2007.11.021.Spagnolo S., Grasso M., Tesler U. F. Retrograde pulmonary perfusion improves results in pulmonary embolectomy. Tex. Heart Ins.t J. 2006; 33: 473–476.Spagnolo S., Grasso M., Tesler U. F. Retrograde pulmonary perfusion improves results in pulmonary embolectomy. Tex. Heart Ins.t J. 2006; 33: 473–476.Zarrabi Kh., Mollazadeh R., Ostovan M. A., Abdi Ardekani A. R. Retrograde pulmonary embolectomy in 11 patients. Ann. Thorac. Surg. 2008; 85 (4): 1471–1472. doi: 10.1016/j.athoracsur.2007.09.005.Zarrabi Kh., Mollazadeh R., Ostovan M. A., Abdi Ardekani A. R. Retrograde pulmonary embolectomy in 11 patients. Ann. Thorac. Surg. 2008; 85 (4): 1471–1472. doi: 10.1016/j.athoracsur.2007.09.005.Donzé J., Le Gal G., Fine M. J., Roy P. M., Sanchez O., Verschuren F. et al. Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism. Thromb. Haemost. 2008; 100: 943–948. doi: http://dx.doi.org/10.1160/TH08-05-0285.Donzé J., Le Gal G., Fine M. J., Roy P. M., Sanchez O., Verschuren F. et al. Prospective validation of the Pulmonary Embolism Severity Index. A clinical prognostic model for pulmonary embolism. Thromb. Haemost. 2008; 100: 943–948. doi: http://dx.doi.org/10.1160/TH08-05-0285.Kipfmueller F., Quiroz R., Goldhaber S. Z., Schoepf U. J., Costello P., Kucher N. Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism. Vasc. Med. 2005; 10 (2): 85–89. doi: 10.1191/1358863x05vm610oa.Kipfmueller F., Quiroz R., Goldhaber S. Z., Schoepf U. J., Costello P., Kucher N. Chest CT assessment following thrombolysis or surgical embolectomy for acute pulmonary embolism. Vasc. Med. 2005; 10 (2): 85–89. doi: 10.1191/1358863x05vm610oa.Kurzyna M., Torbicki A., Pruszczyk P., Burakowska B., Fijałkowska A., Kober J. et al. Disturbed right ventricular ejection pattern as a new Doppler echocardiographic sign of acute pulmonary embolism. Am. J. Cardiol. 2002; 90: 507– 511. doi: http://dx.doi.org/10.1016/S0002-9149(02)02523-7.Kurzyna M., Torbicki A., Pruszczyk P., Burakowska B., Fijałkowska A., Kober J. et al. Disturbed right ventricular ejection pattern as a new Doppler echocardiographic sign of acute pulmonary embolism. Am. J. Cardiol. 2002; 90: 507– 511. doi: http://dx.doi.org/10.1016/S0002-9149(02)02523-7.Chartier L., Béra J., Delomez M., Asseman P., Beregi J. P., Bauchart J. J. et al. Free-floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients. Circulation. 1999; 99: 2779–2783. doi: 10.1161/01.CIR.99.21.2779.Chartier L., Béra J., Delomez M., Asseman P., Beregi J. P., Bauchart J. J. et al. Free-floating thrombi in the right heart: diagnosis, management, and prognostic indexes in 38 consecutive patients. Circulation. 1999; 99: 2779–2783. doi: 10.1161/01.CIR.99.21.2779.Шилова А . Н., Карпенко А . А ., Кармадонова Н. А ., Старосоцкая М . В . Влияние тромбофилических состояний на течение ТЭЛА и эффективность тромболитической терапии. Комплексные проблемы сердечно-сосудистых заболеваний. 2012; 1: 40–42. Shilova A. N., Karpenko A. A., Karmadonova N. A., Starosotskaya M. V. The influence of thrombophilic states for a pulmonary embolism and efficacy of thrombosis therapy. Complex Issues of Cardiovascular Diseases. 2012; 1: 40–42. [In Russ].Шилова А . Н., Карпенко А . А ., Кармадонова Н. А ., Старосоцкая М . В . Влияние тромбофилических состояний на течение ТЭЛА и эффективность тромболитической терапии. Комплексные проблемы сердечно-сосудистых заболеваний. 2012; 1: 40–42. Shilova A. N., Karpenko A. A., Karmadonova N. A., Starosotskaya M. V. The influence of thrombophilic states for a pulmonary embolism and efficacy of thrombosis therapy. Complex Issues of Cardiovascular Diseases. 2012; 1: 40–42. [In Russ].Greer I. A., Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood. 2005; 106: 401–407. doi: http://dx.doi. org/10.1182/blood-2005-02-0626.Greer I. A., Nelson-Piercy C. Low-molecular-weight heparins for thromboprophylaxis and treatment of venous thromboembolism in pregnancy: a systematic review of safety and efficacy. Blood. 2005; 106: 401–407. doi: http://dx.doi. org/10.1182/blood-2005-02-0626.Kameyama K., Huang C. L., Liu D., Okamoto T., Hayashi E., Yamamoto Y. et al. Pulmonary embolism after lung resection: diagnosis and treatment. Ann. Thorac. Surg. 2003; 76: 599–601. doi: http://dx.doi.org/10.1016/S0003-4975(03)00005-5.Kameyama K., Huang C. L., Liu D., Okamoto T., Hayashi E., Yamamoto Y. et al. Pulmonary embolism after lung resection: diagnosis and treatment. Ann. Thorac. Surg. 2003; 76: 599–601. doi: http://dx.doi.org/10.1016/S0003-4975(03)00005-5.Kelly J., Rudd A., Lewis R., Hunt B. J. Venous thromboembolism after acute stroke. Stroke. 2001; 32: 262– 267. doi: 10.1161/01.STR.32.1.262.Kelly J., Rudd A., Lewis R., Hunt B. J. Venous thromboembolism after acute stroke. Stroke. 2001; 32: 262– 267. doi: 10.1161/01.STR.32.1.262.Riera-Mestre A., Jiménez D., Muriel A., Lobo J. L., Moores L., Yusen R. D. et al. Thrombolytic therapy and outcome of patients with an acute symptomatic pulmonary embolism. J. Thromb. Haemost. 2012; 10: 7515759. doi: 10.1111/j.1538-7836.2012.04698.x.Riera-Mestre A., Jiménez D., Muriel A., Lobo J. L., Moores L., Yusen R. D. et al. Thrombolytic therapy and outcome of patients with an acute symptomatic pulmonary embolism. J. Thromb. Haemost. 2012; 10: 7515759. doi: 10.1111/j.1538-7836.2012.04698.x.Wang C., Zhai Z., Yang Y., Wu Q., Cheng Z., Liang L. et al. Efficacy and safety of low dose recombinant tissuetype plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest. 2010; 137: 254–262. doi: 10.1378/ chest.09-0765.Wang C., Zhai Z., Yang Y., Wu Q., Cheng Z., Liang L. et al. Efficacy and safety of low dose recombinant tissuetype plasminogen activator for the treatment of acute pulmonary thromboembolism: a randomized, multicenter, controlled trial. Chest. 2010; 137: 254–262. doi: 10.1378/ chest.09-0765.Wright H. J., Campbell R., Ellis S., Batley M. Thrombolysis for postoperative pulmonary embolism: limiting the risk of hemorrhage. Thorax. 2010; 66: 452. doi: 10.1136/ thx.2010.136614.Wright H. J., Campbell R., Ellis S., Batley M. Thrombolysis for postoperative pulmonary embolism: limiting the risk of hemorrhage. Thorax. 2010; 66: 452. doi: 10.1136/ thx.2010.136614.Zhang K., Zeng X., Zhu C., Xu L., Fu X., Jiang H. et al. Successful thrombolysis in postoperative patients with acute massive pulmonary embolism. Heart Lung Circ. 2013; 22 (2): 100–103. doi:10.1016/j.hlc.2012.08.055.Zhang K., Zeng X., Zhu C., Xu L., Fu X., Jiang H. et al. Successful thrombolysis in postoperative patients with acute massive pulmonary embolism. Heart Lung Circ. 2013; 22 (2): 100–103. doi:10.1016/j.hlc.2012.08.055.Карпенко А . А ., Старосоцкая М . В ., Чернявский М . А ., Чернявский А . М . Отдаленные результаты хирургического лечения массивной тромбоэмболии легочных артерии. Флебология. 2012; 6 (1): 52–55. Karpenko A. A., Starosotskaia M. V., Cherniavskiĭ M. A., Cherniavskiĭ A. M. Long-term results of the surgical treatment of massive pulmonary embolism. Flebologiâ. (Phlebology). 2012; 6 (1): 52–55. [In Russ].Карпенко А . А ., Старосоцкая М . В ., Чернявский М . А ., Чернявский А . М . Отдаленные результаты хирургического лечения массивной тромбоэмболии легочных артерии. Флебология. 2012; 6 (1): 52–55. Karpenko A. A., Starosotskaia M. V., Cherniavskiĭ M. A., Cherniavskiĭ A. M. Long-term results of the surgical treatment of massive pulmonary embolism. Flebologiâ. (Phlebology). 2012; 6 (1): 52–55. [In Russ].Kuo W. T., Gould M. K., Louie J. D., Rosenberg J. K., Sze D. Y., Hofmann L. V. et al. Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques. J. Vasc. Interv. Radiol. 2009; 20: 1431–1440. doi: 10.1016/j.jvir.2009.08.002.Kuo W. T., Gould M. K., Louie J. D., Rosenberg J. K., Sze D. Y., Hofmann L. V. et al. Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques. J. Vasc. Interv. Radiol. 2009; 20: 1431–1440. doi: 10.1016/j.jvir.2009.08.002.Todoran T. M., Sobieszczyk P. Catheter-based therapies for massive pulmonary embolism. Prog. Cardiovasc. Dis. 2010; 52: 429–437. doi: 10.1016/j.pcad.2010.01.002.Todoran T. M., Sobieszczyk P. Catheter-based therapies for massive pulmonary embolism. Prog. Cardiovasc. Dis. 2010; 52: 429–437. doi: 10.1016/j.pcad.2010.01.002.Медведев А . П., Дерябин Р. А ., Немирова С. В ., Демарин О . И ., Пичугин В . В ., Пенкнович А . А . и др. Хирургическое лечение массивной тромбоэмболии легочной артерии у больных пожилого и старческого возраста. Медицинский альманах. 2013; 4 (28): 67–71. Medvedev A. P., Deryabin R. A., Nemirova S. V., Demarin O. I., Pichugin V. V., Penknovich A. A. et al. The surgical treatment of massive thromboembolism of pulmonary artery of patients of elderly and senile age. Medicinskij al’manah. 2013; 4 (28): 67–71. [In Russ].Медведев А . П., Дерябин Р. А ., Немирова С. В ., Демарин О . И ., Пичугин В . В ., Пенкнович А . А . и др. Хирургическое лечение массивной тромбоэмболии легочной артерии у больных пожилого и старческого возраста. Медицинский альманах. 2013; 4 (28): 67–71. Medvedev A. P., Deryabin R. A., Nemirova S. V., Demarin O. I., Pichugin V. V., Penknovich A. A. et al. The surgical treatment of massive thromboembolism of pulmonary artery of patients of elderly and senile age. Medicinskij al’manah. 2013; 4 (28): 67–71. [In Russ].Dauphine C., Omari B. Pulmonary embolectomy for acute massive pulmonary embolism. Ann Thorac. Surg. 2005; 79: 1240–1244. doi: http://dx.doi.org/10.1016/j. athoracsur.2004.08.081.Dauphine C., Omari B. Pulmonary embolectomy for acute massive pulmonary embolism. Ann Thorac. Surg. 2005; 79: 1240–1244. doi: http://dx.doi.org/10.1016/j. athoracsur.2004.08.081.Idrees M. M., Batubara E., Kashour T. Novel approach for the management of sub-massive pulmonary embolism. Ann. Thorac. Med. 2012; 7: 157–161. doi: 10.4103/1817-1737.98850.Idrees M. M., Batubara E., Kashour T. Novel approach for the management of sub-massive pulmonary embolism. Ann. Thorac. Med. 2012; 7: 157–161. doi: 10.4103/1817-1737.98850.Leacche M., Unic D., Goldhaber S. Z., Rawn J. D., Aranki S. F., Couper G. S. et al. Modern surgical treatment of massive pulmonary embolism: results in 47 consecutive patients after rapid diagnosis and aggressive surgical approach. J. Thorac. Cardiovasc. Surg. 2005; 129: 1018–1023. doi: http:// dx.doi.org/10.1016/j.jtcvs.2004.10.023.Leacche M., Unic D., Goldhaber S. Z., Rawn J. D., Aranki S. F., Couper G. S. et al. Modern surgical treatment of massive pulmonary embolism: results in 47 consecutive patients after rapid diagnosis and aggressive surgical approach. J. Thorac. Cardiovasc. Surg. 2005; 129: 1018–1023. doi: http:// dx.doi.org/10.1016/j.jtcvs.2004.10.023.Meneveau N., Séronde M. F., Blonde M. C., Legalery P., Didier-Petit K., Briand F. et al. Management of unsuccessful thrombolysis in acute massive pulmonary embolism. Chest. 2006; 129 (4): 1043–1050. doi:10.1378/chest.129.4.1043.Meneveau N., Séronde M. F., Blonde M. C., Legalery P., Didier-Petit K., Briand F. et al. Management of unsuccessful thrombolysis in acute massive pulmonary embolism. Chest. 2006; 129 (4): 1043–1050. doi:10.1378/chest.129.4.1043.Stein P. D., Alnas M., Beemath A., Patel N. R. Outcome of pulmonary embolectomy. Am. J. Cardiol. 2007; 99: 421– 423. doi: http://dx.doi.org/10.1016/j.amjcard.2006.08.050.Stein P. D., Alnas M., Beemath A., Patel N. R. Outcome of pulmonary embolectomy. Am. J. Cardiol. 2007; 99: 421– 423. doi: http://dx.doi.org/10.1016/j.amjcard.2006.08.050.Vohra H. A., Whistance R. N., Mattam K., Kaarne M., Haw M. P., Barlow C. W. et al. Early and late clinical outcomes of pulmonary embolectomy for acute massive pulmonary embolism. Ann. ThoracSurg. 2011; 90: 1747–1752. doi: 10.1016/j.athoracsur.2010.08.002.Vohra H. A., Whistance R. N., Mattam K., Kaarne M., Haw M. P., Barlow C. W. et al. Early and late clinical outcomes of pulmonary embolectomy for acute massive pulmonary embolism. Ann. ThoracSurg. 2011; 90: 1747–1752. doi: 10.1016/j.athoracsur.2010.08.002.Taniguchi S., Fukuda W., Fukuda I., Kenichi W. et al. Outcome of pulmonary embolectomy for acute pulmonary thromboembolism: analysis of 32 patients from a multicenter registry in Japan. Interact. Cardiovasc. and Thorac. Surg. 2012; 14: 64–67. doi: 10.1093/icvts/ivr018.Taniguchi S., Fukuda W., Fukuda I., Kenichi W. et al. Outcome of pulmonary embolectomy for acute pulmonary thromboembolism: analysis of 32 patients from a multicenter registry in Japan. Interact. Cardiovasc. and Thorac. Surg. 2012; 14: 64–67. doi: 10.1093/icvts/ivr018.

The authors declare that there are no conflicts of interest present.