Pulmonary vascular disease & thromboembolismRandomised controlled trial
Low-dose, short-duration catheter-directed thrombolysis for acute intermediate-high-risk pulmonary embolism: the BETULA trial
- open-label, randomised controlled trial
Authors' conclusion
Low-dose, short-duration CDT plus UFH improved the RV/LV ratio without increasing major bleeding compared with UFH alone in intermediate-high-risk PE.
Study context
- Population
- Patients with acute intermediate-high-risk pulmonary embolism (PE)randomised, 58 completing follow-up · catheter-directed thrombolysis (CDT) 29 · unfractionated heparin (UFH) 29
- Participants
- 60 patients
- Comparison
- low-dose, short-duration CDT compared with unfractionated heparin
- CDTn = 29
- UFHn = 29
- Primary endpoint
- Change in RV/LV ratio
- Follow-up
- 24 hours
Primary result
As reported in the abstract
CDT
−0.17
change
UFH
+0.02
change
P = 0.01
Secondary outcomes
| Outcome | CDT | UFH |
|---|---|---|
| Death | Not reported in the abstract | One events |
Secondary endpoints (thrombus burden reduction, vital signs, echocardiographic RV function, length of hospital stay, 30-day mortality, 90-day recurrent PE)
- Secondary endpoints did not differ between groups
Safety
Minor bleeding
P = 0.29
- Haemodynamic deterioration during CDT
- One · events
Major bleeding
- No major bleeding occurred
Original publication
Low-dose, short-duration catheter-directed thrombolysis for acute intermediate-high-risk pulmonary embolism: the BETULA trial. EuroIntervention. Published 17 August 2026. doi:10.4244/eij-d-26-00292
Summarised from the published abstract; every number is checked against it