2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults
This is a de novo American guideline — the first ACC/AHA document devoted to acute pulmonary embolism — and its central act is nomenclature: it retires 'massive/submassive' and introduces the AHA/ACC Acute Pulmonary Embolism Clinical Categories, a severity scheme that sits alongside, but does not map one-to-one onto, the ESC 2019 high/intermediate-high/intermediate-low/low-risk stratification. Direct oral anticoagulants remain the default, full-dose systemic fibrinolysis remains reserved for haemodynamic collapse, and catheter-directed therapy is given a more permissive, PE-response-team-mediated role than in the European document, while both acknowledge that the randomised evidence for it is still thin. The register's anticoagulation, reperfusion and reversal trials are grouped below.
This guideline cites 4 of the 199 landmark trials in our Cardiology register.
Anticoagulation — direct oral anticoagulants1
- 2013HOKUSAI-VTECardiology · Thrombosis · Venous thromboembolismEdoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism
Cancer-associated venous thromboembolism1
- 2020CARAVAGGIOCardiology · Thrombosis · Venous thromboembolismApixaban for the Treatment of Venous Thromboembolism Associated with Cancer