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Venous thromboembolic disease presenting with acute pulmonary embolus (PE) can be treated in a variety of ways from anticoagulation as an outpatient to surgical embolectomy with many new interventional therapies being developed. Mortality in these patients can be as high as 50% and many of these treatments are also considered to be high risk. Early involvement of a multidisciplinary team and patient risk stratification can aid management decisions in these complex patients who can suddenly deteriorate. In this review, we summarise the evidence behind new and developing interventional therapies in the treatment of high and intermediate‐high risk PE including catheter‐directed thrombolysis, pharmacomechanical thrombolysis, thromboaspiration and the growing role of extracorporeal membrane oxygenation in the stabilisation and management of this cohort of patients. [ABSTRACT FROM AUTHOR]

Objective: To develop an alpha dosimetry technique for activity calibration of alpha-emitting radiopharmaceuticals using the Gafchromic EBT3 (Gaf-EBT3) radio chromic film (International Speciality product, Wayne, NJ). Methods: The Gaf-EBT3 has a tissue equivalent radiosensitive layer (approximately 28p,m) sandwiched between two 100-μm thick polyester sheaths, thereby making it insensitive to alpha particles. We have split a Gaf-EBT3 sheet using a surgical scalpel to remove one of the polyester protective layers and covered the radiosensitive layer with thin Mylar* foil (Goodfellow Cambridge Limited, Huntingdon, UK) (2.5μm). Small pieces of modified film were exposed at contact with a 560-Bq thin 241Am source for 5, 10, 24 and 94 h. The optical density of the films was evaluated using an optical densitometer. The alpha energy spectra of the 241Am source were recorded using a Si(Li) surface barrier detector. Results: Time-integrated specific alpha surface activity ( kBq cm-2h) was represented as a function of optical density. Conclusion: By removing one of the 100 μm thick polyester protective layers, the authors have modified the Gaf- EBT3 film to a sensitive alpha dosemeter. The calibration function relevant to a 241,Am reference source was evaluated from the optical densities of the dosemeter foils. Furthermore, calibration functions for important alpha emitters such as 223Ra, 225Ac or 210Bi were parameterized from the 241Am reference data. Advances in knowledge: The authors have developed and tested the principle of a clinical alpha dosemeter using Gaf-EBT3 radiochromic films originally developed for photon dosimetry. This novel, user-friendly technique could be implemented in quality assurance and calibration procedures of important alpha-emitting radiopharmaceuticals prior to their clinical applications. [ABSTRACT FROM AUTHOR]