6th July 2026

Management

The treatment of a PE is largely the same as DVT – anticoagulation, taking into consideration the same contraindications, comorbidities, and patient preferences as stated previously. Treatment will be continued for at least 3 months. IVC filters and thrombolytic therapy are other candidates for treatment if anticoagulation is contraindicated or not tolerated. 

In the event that a patient is haemodynamically unstable, patients should be managed with a continuous unfractionated heparin infusion with a consideration for thrombolytic therapy. 

Indications for thrombolytic therapy are: 

• Patients with symptomatic iliofemoral DVT with symptoms lasting less than 14 days, 
• and good functional status  
• and life expectancy of at least 1 year 
• and low bleeding risk.  

Treatment should be started immediately and not be delayed by imaging or other investigations in the event massive PE is suspected.