Rationale for and approach to establishing a multidisciplinary acute pulmonary embolism expert care team

Patients with acute pulmonary embolism (PE) may present with cardiac arrest, overt or impending cardiogenic shock and/or severe respiratory insufficiency. Immediate evaluation and management of these patients require high clinical suspicion along with (bedside) imaging to confirm the diagnosis, targeted haemodynamic and/or respiratory support, appropriate anticoagulant treatment, and in many cases reperfusion therapy. The immediate treatment decision-making is largely driven by local expertise and resources and should be guided by the individual patient's characteristics such as cardiopulmonary comorbidities, risk of bleeding and location, extent and haemodynamic impact of the clot. Over the past years, treatment options for patients with severe PE have expanded substantially. For instance, several new catheter-guided reperfusion therapies have emerged and experience with circulatory mechanical support has increased. Along with the rise of new interventional therapies has come the introduction of expert multidisciplinary pulmonary embolism (EXPERT-PE) care teams, composed of multidisciplinary specialists involved in treating severe acute PE. This model of care provides a platform for rapid decisions on individualized treatment strategies, combining expert opinion from all involved specialties, setting the quality standards for modern local and regional equity PE care, and forming the base for future research in this area. Clinical decisions should be evidence-based where possible, and incorporate the individual patient's and their carer's preferences, values, and priorities, as well as those of the managing clinicians and care team. In this review, we summarize the evidence for the introduction of EXPERT-PE care teams and provide a practical manual for their successful implementation.

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Publication Details

Journal
European Heart Journal Acute Cardiovascular Care
Published
2025-10-28
DOI
https://doi.org/10.1093/ehjacc/zuaf141
Citations
3
Primary Topic
Venous Thromboembolism Diagnosis and Management
Type
article
Field-Weighted Citation Impact
5.61
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article

Rationale for and approach to establishing a multidisciplinary acute pulmonary embolism expert care team

Olivier Sanchez, Laurent Bertoletti, Maria Cristina Vedovati, Ingo Ahrens et al.
3 citations
European Heart Journal Acute Cardiovascular Care
Venous Thromboembolism Diagnosis and Management
5.61
article

Rationale for and approach to establishing a multidisciplinary acute pulmonary embolism expert care team

Olivier Sanchez, Laurent Bertoletti, Maria Cristina Vedovati, Ingo Ahrens, W. Brent Keeling, Milica Aleksić, Julie Helms, Roberto Pola, Menno V. Huisman, Jacob Gammelgaard Schultz, Oliver Schlager, José M. Montero Cabezas, Ignacio Martín‐Loeches, Stefano Barco, Stavros Konstantinides, Roberto Lorusso, Frederikus Albertus Klok, Peter Verhamme, Ümit Yaşar Si̇nan, Fionnuala Ní Áinle, Piotr Pruszczyk, Mandy N. Lauw, Iréne Lang, Lilian J. Meijboom, Karl Fengler, Andrew Sharp, Nicolas Meneveau, Gerry O’Sullivan, David Jiménez, Ahmed Zaher
article en
3 citations

Abstract

Patients with acute pulmonary embolism (PE) may present with cardiac arrest, overt or impending cardiogenic shock and/or severe respiratory insufficiency. Immediate evaluation and management of these patients require high clinical suspicion along with (bedside) imaging to confirm the diagnosis, targeted haemodynamic and/or respiratory support, appropriate anticoagulant treatment, and in many cases reperfusion therapy. The immediate treatment decision-making is largely driven by local expertise and resources and should be guided by the individual patient's characteristics such as cardiopulmonary comorbidities, risk of bleeding and location, extent and haemodynamic impact of the clot. Over the past years, treatment options for patients with severe PE have expanded substantially. For instance, several new catheter-guided reperfusion therapies have emerged and experience with circulatory mechanical support has increased. Along with the rise of new interventional therapies has come the introduction of expert multidisciplinary pulmonary embolism (EXPERT-PE) care teams, composed of multidisciplinary specialists involved in treating severe acute PE. This model of care provides a platform for rapid decisions on individualized treatment strategies, combining expert opinion from all involved specialties, setting the quality standards for modern local and regional equity PE care, and forming the base for future research in this area. Clinical decisions should be evidence-based where possible, and incorporate the individual patient's and their carer's preferences, values, and priorities, as well as those of the managing clinicians and care team. In this review, we summarize the evidence for the introduction of EXPERT-PE care teams and provide a practical manual for their successful implementation.

European Heart Journal Acute Cardiovascular CareVol. 15(2)
University College Dublin (IE), Università Cattolica del Sacro Cuore (IT), Saint-Gobain (France) (FR), PAST Foundation (US), Emory University (US), Inserm (FR), Universidad de Alcalá (ES), Johannes Gutenberg University Mainz (DE), Aarhus University (DK), Université Paris Cité (FR), Trinity College Dublin (IE), Medical University of Warsaw (PL), University of Perugia (IT), Leiden University Medical Center (NL), Maastricht University Medical Centre (NL), Erasmus MC (NL), Aarhus University Hospital (DK), Pulmonary Hypertension Association (US), Agostino Gemelli University Polyclinic (IT), University Hospital Galway (IE), Mater Misericordiae University Hospital (IE), Cardiovascular Institute Hospital (JP), Mines Saint-Étienne (FR), Maastricht University (NL), Regenerative NanoMedicine (FR), Centre Hospitalier Universitaire de Besançon (FR), University Medical Center of the Johannes Gutenberg University Mainz (DE), Assistance Publique – Hôpitaux de Paris (FR), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (ES), University Hospital of Zurich (CH), Hôpital Européen Georges-Pompidou (FR), Hôpital Européen (FR), Krankenhaus der Augustinerinnen (DE), Istanbul University-Cerrahpaşa (TR), Leipzig Heart Institute (DE), Instituto Ramón y Cajal de Investigación Sanitaria (ES), Paris Cardiovascular Research Center (FR), Oxford University Hospitals NHS Trust (GB), Institut Pasteur du Maroc (MA), Amsterdam University Medical Centers (NL), Universitätszahnklinik Wien (AT), St. James's Hospital (IE), University Hospital Medical Center Bezanijska kosa (RS), French Clinical Research Infrastructure Network (FR), Istanbul University (TR), Université de Strasbourg (FR), Medical University of Vienna (AT), Vrije Universiteit Amsterdam (NL), Université Jean Monnet (FR), KU Leuven (BE)
Openalex Percentile: Top 3%
Venous Thromboembolism Diagnosis and Management
5.61
DOISourceOpenAlex
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