Pulmonary vascular disease & thromboembolismResearch article
Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE
- Patients enrolled in SYMPHONY-PE (Symphony Pulmonary Embolism) trial were divided into one of 2 groups based on the time from baseline computed tomography pulmonary angiography to mechanical thrombectomy
Authors' conclusion
Early mechanical thrombectomy was associated with larger reductions in right ventricle-to-left ventricle ratio and mean pulmonary artery pressure, with no significant differences in safety event rates compared with patients who underwent late thrombectomy. Randomized trials are needed to test these associations.
Study context
- Population
- Patients with intermediate-risk pulmonary embolism (PE) treated with mechanical thrombectomy in the SYMPHONY-PE trial48/109 received early thrombectomy
- Participants
- 109 patients
- Comparison
- Early <12 hours versus late ≥12 hours
- Earlyn = 48
- Outcome
- Core-lab assessed mean change in right ventricle-to-left ventricle ratio (primary efficacy end point); rate of major adverse events (primary safety end point)
- Follow-up
- Baseline to 48 hours
Main finding
As reported in the abstract
Early
0.52
reduction · ± 0.50
Late
0.37
reduction · ± 0.34
Early vs Late: P = 0.071 · Early vs Late: P = 0.431
Further findings
Mean pulmonary artery pressure decrease · decreased significantly more with early
P = 0.006
Efficacy outcomes by Composite Pulmonary Embolism Shock score
- Differences in efficacy outcomes were greatest in higher-risk patients
Safety
Mortality
- no mortalities
Original publication
Summarised from the published abstract; every number is checked against it