Acute pulmonary embolism（APE） in operation room is a constant

lethal but treatable disease.A fast determination of APE in an operation room is currently difficult due to a non-specificity on its signs

symptoms

electrocardiograph findings

arterial blood gas abnormalities and chest X-rays.Clinically

an APE can automatically originate from a small and clinically asymptomatic embolus to massive

proximal emboli with shock during a scheduled surgery period.An accurate

brief and prompt diagnostic and therapeutic strategy for APE in a peri-operation period is crucial for anesthesiologists to make a decision on an appropriate clinical intervention to improve patients’ outcomes.The purpose of this mini-review article is to illuminate a fast-track diagnostic and therapeutic strategy for APE patients in a perioperative period through a hybrid of the high sensitive and high specific viable diagnostic modality of D-dimer assay in conjunction with necessary emergent pulmonary angiography（EPA）

including digital subtraction angiography（DSA）

or a spiral computed tomography angiography（sCTA） for APE patients’ diagnosis and treatment during operation.The postulated fast-track diagnostic and therapeutic strategy can effectively confirm or exclude highly suspected APE and simultaneously provide fast therapeutic opportunities for APE patients at an operative period.