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Khachyatryan A.S.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Rylnikov D.V.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Khachyatryan R.S.

Pirogov Russian National Research Medical University, Moscow, Russia

Seliverstov E.I.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

An E.S.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Zolotukhin I.A.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Outpatient Treatment of Hemodynamically Stable Patients with Pulmonary Embolism

Authors:

Khachyatryan A.S., Rylnikov D.V., Khachyatryan R.S., Seliverstov E.I., An E.S., Zolotukhin I.A.

More about the authors

Journal: Journal of Venous Disorders. 2026;20(1): 26‑33

DOI: 10.17116/flebo20262001126

Read: 733 times

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Table of contents

OUTPATIENT TREATMENT OF HEMODYNAMICALLY STABLE PATIENTS WITH PULMONARY EMBOLISM
OUTPATIENT TREATMENT OF HEMODYNAMICALLY STABLE PATIENTS WITH PULMONARY EMBOLISM

To cite this article:

Khachyatryan AS, Rylnikov DV, Khachyatryan RS, Seliverstov EI, An ES, Zolotukhin IA. Outpatient Treatment of Hemodynamically Stable Patients with Pulmonary Embolism. Journal of Venous Disorders. 2026;20(1):26‑33. (In Russ.)
https://doi.org/10.17116/flebo20262001126

Подписка 2026 Флебология (Journal of Venous Disorders)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To evaluate the efficacy and safety of outpatient treatment of pulmonary embolism (PE) using standard anticoagulant therapy (ACT) with direct oral anticoagulants.

MATERIAL AND METHODS

A prospective, observational study was conducted in patients with PE. The analysis included fifty patients with a first-time diagnosis of PE who received outpatient treatment. Outpatient management was defined as discharge from the emergency (diagnostic) department after completion of additional evaluation and confirmation of PE. The primary outcomes were the incidence of symptomatic recurrent venous thromboembolism (VTE) and bleeding events following initiation of ACT. Secondary outcomes included VTE-related mortality and all-cause mortality, readmission to emergency departments, and non-adherence to ACT.

RESULTS

The mean age of patients was 65±10 years, with a predominance of women (n=29; 58%). The most common presenting symptoms were lower extremity edema (24%) and dyspnea (16%). PE involved the segmental and subsegmental pulmonary arteries in 84% of patients, submassive PE was diagnosed in 10% of subjects, and massive PE — in 4%. Furthermore, 44 (88%) of patients developed PE in addition to oncological disease. Recurrent VTE within 3 months was observed in 1 (2%) patient. No major or clinically relevant bleeding events occurred, and minor bleeding was reported in 1 (2%) patient. Non-adherence to ACT was noted in 2 (4%) patients. During the study, five deaths (10%) occurred, none of which were VTE-related.

CONCLUSION

Outpatient management of hemodynamically stable patients with pulmonary embolism is effective and safe when proper risk stratification and careful evaluation of individual complication risks are ensured.

Keywords:

deep vein thrombosis
pulmonary embolism
outpatient treatment

Authors:

Khachyatryan A.S.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Rylnikov D.V.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Khachyatryan R.S.

Pirogov Russian National Research Medical University, Moscow, Russia

Seliverstov E.I.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

An E.S.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Zolotukhin I.A.

Pirogov Russian National Research Medical University, Moscow, Russia;
Pirogov City Clinical Hospital No. 1, Moscow, Russia

Received:

02.12.2025

Accepted:

20.01.2026

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