Mechanical Thrombectomy Versus Conventional Anticoagulants Alone in Treatment of Pulmonary Embolism: A Systematic Review and Meta‐Analysis
Notice bibliographique
Résumé
ABSTRACT Pulmonary embolism (PE) is a life‐threatening condition and a leading cause of sudden death. It occurs when a thrombus develops in the venous system and then dislodges to embolize into the pulmonary arteries, causing obstruction. The current mainstay of treatment is anticoagulation. Adjunct mechanical thrombectomy (MT) or pharmacological thrombolysis may be added, following a risk assessment, for intermediate to massive PE. However, physicians remain reluctant to adopt them as first‐line treatment when comparing the benefits and risks to anticoagulation alone. This study aims to compare the safety and efficacy of MT with anticoagulation therapy alone in the treatment of intermediate to large‐sized PE patients, focusing on hospital stay, ICU admission, morbidity, and mortality. Following PRISMA guidelines, a search was conducted on PubMed, Scopus, Web of Science, and Google Scholar for studies published from inception up to July 5, 2025. Studies were then screened based on predefined inclusion and exclusion criteria. The Newcastle−Ottawa Scale was used to assess the quality of evidence. Studies were required to report at least one of the following outcomes: mortality rate, hospital stay, overall complications, and ICU stay. Screening & data were extracted independently by eight co‐authors, and a senior co‐author resolved all conflicts. From a pool of 5661 studies, a total of six studies (1509 patients) were included. MT was associated with a trend toward lower all‐cause mortality (OR = 0.5, 95% CI, 0.27 to 1.01; p = 0.05; I 2 = 46%) and a significantly lower rate of ICU length of stay by 3.0 days than those in the anticoagulant therapy group (MD: − 3.01, 95% CI, −5.57 to −0.44, p = 0.02; I 2 = 83%). No significant difference was found in overall complications and length of hospital stay between the MT and anticoagulant groups. However, MT was associated with lower rates of overall complications by 49% (OR = 0.51, 95% CI, 0.10 to 2.67, p = 0.43; I 2 = 83%) and shorter hospital stays (MD: −0.76; 95% CI, −4.64 to 3.13, p = 0.70; I 2 = 93%). MT showed greater efficacy in reducing mortality rates and ICU stay compared to intermediate to high‐risk PE patients treated with conventional anticoagulant therapy.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».