🫁 Anticoagulation vs Thrombolysis Decision Simulator

Classifying PE Severity Before Choosing Therapy

Severity class sets the whole treatment path forward.

• ~60%: Low-risk PE share (placeholder stat)
• ~35%: Submassive PE share (placeholder stat)
• ~5%: Massive PE share (placeholder stat)
• ~30%: Massive PE mortality (placeholder stat)

How severity is determined

Placeholder: imaging, biomarkers, and vitals set risk class.

Why classification comes first

Placeholder: treatment intensity must match clot burden and instability.

Heparin Bridge to DOAC for Stable PE

Most patients start anticoagulation, not clot-dissolving drugs.

• Heparin: First-line agent (placeholder stat)
• ~5 days: Bridge duration (placeholder stat)
• ~2%: Major bleeding risk (placeholder stat)
• DOAC: Long-term agent (placeholder stat)

Why anticoagulation is default

Placeholder: favorable risk-benefit for stable, non-massive PE.

Heparin-to-DOAC transition

Placeholder: overlap dosing until DOAC reaches steady state.

How Anticoagulation Clears Clot Without Dissolving It Directly

The body's own fibrinolysis does the dissolving, slowly.

• ~1–2 wks: Clot half-clearance (placeholder stat)
• Blocked: New clot growth (placeholder stat)
• Weeks–months: Full resolution (placeholder stat)
• ~90%: Recurrence reduction (placeholder stat)

Preventing propagation

Placeholder: anticoagulants stop the clot from growing further.

Natural fibrinolysis at work

Placeholder: endogenous plasmin gradually breaks down existing clot.

Thrombolysis for Hemodynamically Unstable PE

Rapid clot dissolution is weighed against major bleeding risk.

• Hours: Clot dissolution time (placeholder stat)
• ~10–12%: Major bleeding risk (placeholder stat)
• ~2–3%: Intracranial hemorrhage (placeholder stat)
• Alteplase: Agent (placeholder stat)

When thrombolysis is considered

Placeholder: reserved for shock or hemodynamic collapse.

The bleeding tradeoff

Placeholder: rapid benefit weighed against hemorrhage risk.

Matching Treatment Intensity to Severity

Anticoagulation for most; thrombolysis only when life-threatening.

• ~95%: Anticoagulation-treated (placeholder stat)
• ~5%: Thrombolysis-treated (placeholder stat)
• Avoidable: Mismatch bleeding risk (placeholder stat)
• Avoidable: Mismatch undertreatment risk (placeholder stat)

Why matching matters

Placeholder: mismatched therapy raises harm without added benefit.

Placeholder: severity-matched therapy optimizes risk-benefit outcomes.