Embolismo pulmonar y trombosis venosa profunda: aspectos clínicos y terapéuticos
DOI:
https://doi.org/10.18041/2665-427X/ijeph.1.10718Palabras clave:
Procedimientos endovasculares, Trombosis de la vena, Embolia pulmonar, Trombectomía, Terapia trombolítica, Trombólisis mecánicaResumen
Introducción: el tromboembolismo venoso abarca la trombosis venosa profunda y la embolia pulmonar; representa la tercera enfermedad vascular más importante, provocando alta morbimortalidad potencialmente prevenible. El tratamiento se centra en la anticoagulación temprana para prevenir complicaciones, pero que no siempre restaura la permeabilidad venosa. En este escenario, la trombólisis es una opción, especialmente en pacientes con compromiso hemodinámico significativo o con afectación de segmentos anatómicos de alto riesgo; sin embargo, quienes no son candidatos para recibir trombolíticos, suponen un desafío mayor.
Objetivo: presentar las características clínicas, diagnósticas y terapéuticas, enfatizando en las opciones endovasculares disponibles, describiendo sus técnicas e indicaciones, destacando sus beneficios y su seguridad para tratar pacientes con tromboembolismo venoso.
Métodos: revisión narrativa a partir de la búsqueda bibliográfica en las bases de datos de PubMed y Scielo.
Conclusión: Esta revisión destaca las técnicas de manejo endovascular para tromboembolismo venoso frente a la terapia trombolítica clásica sobre todo en pacientes con alto riesgo de sangrado; así como en quienes están contraindicados los trombolíticos sistémicos como los nuevos anticoagulantes orales por el compromiso hemodinámico. Entre las opciones que se tienen de terapia endovascular está la trombólisis dirigida por catéter y la embolectomía cutánea, que presentan menores tasas de recurrencia y complicaciones posteriores a su aplicación, resaltando que la elección debe ser individualizada en cada paciente
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