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Therapeutic management has evolved from a dichotomous paradigm (anticoagulation vs. thrombolysis) to a risk-stratified approach based on early mortality risk and right ventricular 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 guidelines and recent clinical trials.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suag050","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T12:52:33Z","timestamp":1772628753000},"page":"v173-v176","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of acute pulmonary embolism: anticoagulation, fibrinolysis, and thrombectomy compared"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0676-3132","authenticated-orcid":false,"given":"Giovanna","family":"Manzi","sequence":"first","affiliation":[{"name":"Cardiology Unit, Department of Internal Medicine and Medical Specialties, AOU Policlininco Umberto I\u2014Sapienza University of Rome, Viale del Policlinico 155, 00185 Rome 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