Treatment of Acute Pulmonary Embolism: Anticoagulation, Fibrinolysis, and Thrombectomy Compared

Abstract Acute pulmonary embolism (PE) represents a major clinical challenge, characterised by a wide spectrum of phenotypic presentations ranging from asymptomatic disease to cardiovascular collapse. Therapeutic management has evolved from a dichotomous paradigm (anticoagulation vs thrombolysis) to a risk-stratified approach based on early mortality risk and right ventricular (RV) function. This article critically reviews current evidence regarding parenteral and oral anticoagulation, systemic thrombolysis, and emerging catheter-directed thrombectomy techniques, in light of the 2019 European Society of Cardiology (ESC) guidelines and recent clinical trials.