PE Treatments


PE Treatments

Blood Thinners

Anticoagulant medications (‘blood thinners’) are the most common form of treatment for pulmonary embolism. Anticoagulants work to stabilize the blood clot and prevent it from growing and traveling while the body works to dissolve it over time. You may be admitted to the hospital or observed for a few days if diagnosed with a pulmonary embolism, or if you are at low risk for complications, home therapy may be an option.

In many cases patients are started on either heparin (an intravenous medication), or low-molecular weight heparin (such as enoxaparin or Lovenox), or fondaparinux which are injected under the skin.

Anticoagulant medications are frequently given in a pill form, and there are now several new options available.  Your health care provider may prescribe a blood thinner for outpatient treatment of your pulmonary embolism using one of two newer medications rivaroxaban (Xarelto) or apixaban (Eliquis). These two anticoagulants do not require a shot or intravenous injection to be given along with them.

Other options like warfarin (Coumadin), or one of the other newer blood thinners like dabigatran (Pradaxa), or edoxaban (Savaysa) will require either injections or an intravenous medication for at least 5 days.

How long you stay on blood thinners is based on many factors, and it is important that you work closely with your health care provider to decide what is best for you.  Treatment with blood thinners is usually recommended for a minimum of 3 months but in some cases even longer.   It is very important that you take your medication as prescribed, and let your health care team know if you are planning on having any surgery or procedures that may require you to adjust your blood thinner medication.  Bleeding is a common side effect of all blood thinners.  Most bleeding is minor, and may include nosebleeds or blood in your urine, and your skin may bruise more easily while on these medications.  More serious bleeding may require medical attention, and it is important to let your provider know if you have any signs of serious bleeding, such as blood in your urine or stool.

More Advanced Therapies for PE

IVC Filters – Blood clots that develop in the veins of the leg or pelvis can break up and travel to the lungs causing a pulmonary embolism. An inferior vena cava filter (IVC) filter traps blood clots and prevents further clots from the legs from traveling to the lungs. Filters are often used if a patient is unable to take a blood thinner and may be a temporary device.  These can often be removed with a minor surgical procedure once no longer needed.

Clot Busting Drugs or surgery – Medicines that break up or remove the blood clot may be necessary in some cases. These are given by doctors in the hospital when you first present with a more serious pulmonary embolism either through a vein or by catheter-directed therapy or surgery.