Catheter-Directed Thrombolysis in Intermediate-High-Risk Pulmonary Embolism.

Catheter-directed thrombolysis reduces the risk of death, recurrence, or cardiorespiratory collapse within 7 days in patients with intermediate-high-risk pulmonary embolism, with only minimal bleeding risks.

• Why it matters: Effective treatment options for intermediate-high-risk pulmonary embolism are limited, and improving outcomes could significantly reduce mortality and morbidity in this patient group.
• What they did: A multicenter, randomized trial assigned 558 patients to receive either catheter-directed thrombolysis with alteplase plus anticoagulation or anticoagulation alone, measuring outcomes over 7 days.
• The result: The thrombolysis group experienced a primary outcome event rate of 0.7%, compared to 6.8% in the standard-care group, with similar bleeding risks, indicating thrombolysis improves short-term survival and stability.