Venous thromboembolism (VTE) is the third most common cause of cardiovascular disease after myocardial infarction and stroke. Population-based studies estimate that up to 94,000 new cases of pulmonary embolism (PE) occur in the United States annually with an increasing incidence with age. Mortality from PE is the greatest in the first 24 hours, with a decreased survival extending out 3 months. Thus, acute PE is a potentially fatal illness if not recognized and treated in a timely manner. Contemporary management includes systemic anticoagulation, thrombolysis, catheter-based procedures, and surgical embolectomy. This article reviews current clinical evidence and societal guidelines for the use of systemic and catheter-directed thrombolysis for treatment of acute PE.

静脉血栓栓塞症 (VTE) 是继心肌梗塞和中风之后心血管疾病的第三大常见原因。基于人群的研究估计，美国每年发生多达 94,000 例肺栓塞 (PE) 新病例，且发病率随着年龄的增长而增加。PE 的死亡率在最初的 24 小时内最高，存活率下降延长至 3 个月。因此，如果不及时发现和治疗，急性 PE 是一种潜在的致命疾病。现代管理包括全身抗凝、溶栓、导管手术和手术取栓。本文回顾了使用全身和导管导向溶栓治疗急性 PE 的当前临床证据和社会指南。