尽管有丰富的临床创新和蓬勃发展的科学研究，肺栓塞（PE）仍然在全世界范围内构成诊断和管理挑战。人口老龄化、患有越来越多慢性疾病（特别是癌症）的患者以及日益普遍的医疗保健差距预示着PE负担日益加重。与此同时，探索扩大即时和长期抗凝策略以及先进疗法（包括对更严重肺栓塞患者进行导管干预）已变得越来越令人畏惧。因此，临床医生经常求助于基于证据的临床实践指南来获取诊断和管理建议。然而，众多的国际指南、建议的异质性以及不确定或遗漏的领域可能会让读者和临床医生没有明确的管理途径。在对国际 PE 指南的回顾中，我们强调了一致性、差异性和缺乏建议（沉默）的关键领域，重点关注关键的临床和研究需求。版权所有 © 2024 美国心脏病学会基金会。由爱思唯尔公司出版。保留所有权利。

Despite abundant clinical innovation and burgeoning scientific investigation, pulmonary embolism (PE) has continued to pose a diagnostic and management challenge worldwide. Aging populations, patients living with a mounting number of chronic medical conditions, particularly cancer, and increasingly prevalent health care disparities herald a growing burden of PE. In the meantime, navigating expanding strategies for immediate and long-term anticoagulation, as well as advanced therapies, including catheter-based interventions for patients with more severe PE, has become progressively daunting. Accordingly, clinicians frequently turn to evidence-based clinical practice guidelines for diagnostic and management recommendations. However, numerous international guidelines, heterogeneity in recommendations, as well as areas of uncertainty or omission may leave the readers and clinicians without a clear management pathway. In this review of international PE guidelines, we highlight key areas of consistency, difference, and lack of recommendations (silence) with an emphasis on critical clinical and research needs.Copyright © 2024 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.