American Society of Hirudotherapy

Submassive Pulmonary Embolism.

Review published in American journal of respiratory and critical care medicine (2018)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewClinical TrialsDrug DevelopmentRali et al. · American journal of respiratory and critical care medicine, 2018

Abstract

Pulmonary embolism (PE) presents a spectrum of hemodynamic consequences, ranging from being asymptomatic to a life-threatening medical emergency. Management of submassive and massive PE often involves clinicians from multiple specialties, which can potentially delay the development of a unified treatment plan. In addition, patients with submassive PE can deteriorate after their presentation and require escalation of care. Underlying comorbidities such as chronic obstructive pulmonary disease, cancer, congestive heart failure, and interstitial lung disease can impact the patient's hemodynamic ability to tolerate submassive PE. In this review, we address the definitions, risk stratification (clinical, laboratory, and imaging), management approaches, and long-term outcomes of submassive PE. We also discuss the role of the PE response team in management of patients with PE.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsComputed Tomography AngiographyEmbolectomyHumansPulmonary ArteryPulmonary EmbolismSeverity of Illness IndexVena Cava Filters

Summary

Pulmonary embolism (PE) presents a spectrum of hemodynamic consequences, ranging from being asymptomatic to a life-threatening medical emergency. Management of submassive and massive PE often involves clinicians from multiple specialties, which can potentially delay the development of a unified treatment plan. In addition, patients with submassive PE can deteriorate after their presentation and require escalation of care.

Why This Matters for Hirudotherapy

This review of submassive pulmonary embolism covers definitions, clinical/laboratory/imaging risk stratification, management approaches, long-term outcomes, and the role of a multidisciplinary PE response team, noting that submassive PE patients can deteriorate and require escalation of care and that comorbidities (COPD, cancer, heart failure, interstitial lung disease) affect hemodynamic tolerance. For ASH this sits within the general thrombosis/anticoagulation evidence base rather than touching hirudotherapy directly; it usefully illustrates the severity spectrum and acute-management context of venous thromboembolic disease against which anticoagulant strategies are weighed. As a narrative review it summarizes existing practice and generates no new data, and it makes no claim about leech-derived therapy, so its bearing on hirudotherapy is contextual and modest.

Citation

Submassive Pulmonary Embolism.

Rali et al. · American journal of respiratory and critical care medicine, 2018

Added to ASH library: May 28, 2026 · Site last updated: June 18, 2026

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