Pulmonary vascular disease & thromboembolismCohort study
Mechanical Thrombectomy and Catheter-Directed Thrombolysis in Acute Pulmonary Embolism
- Prospective registry study
- multicentre
- 48 US institutions
- mixed-effects models
Authors' conclusion
Over the past decade, MT has rapidly replaced CDT as predominant catheter-based therapy for acute PE, reflecting both technological innovation and evolving operator confidence.
Study context
- Population
- Intermediate- or high-risk acute pulmonary embolism (PE) treated with advanced therapies, Pulmonary Embolism Response Team (PERT) Consortium Registry, 2016–2024
- Participants
- 2,958 participants · 48 US institutions
- Exposure
- Mechanical thrombectomy (MT) vs catheter-directed thrombolysis (CDT)
- Outcome
- Temporal trends in use of systemic thrombolysis, CDT and MT
- Follow-up
- 2016 to 2024
Main finding
Temporal trends in use
Incidence rate ratio
1.18
95% CI 1.14–1.23
MT
IRR 1.18 (95% CI 1.14–1.23)
Per year, as printed
As reported in the abstract
- CDT use declined per year
- 13%
- Systemic thrombolysis use declined per year
- 12%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Factors associated with MT vs CDT — MT vs CDT · age ≥70 years | 1.37 (1.04–1.81) | |
| Factors associated with MT vs CDT — MT vs CDT · male sex | 1.54 (1.19–1.99) | |
| 0.512Odds ratio (log scale) |
Factors associated with MT vs CDT
- MT also associated with vasopressor use, ECMO support, saddle embolus or clot in transit; CDT more often in younger female patients and with cardiorespiratory symptoms
Risk category of treated patients
- Intermediate-risk PE
- 75.9%
- High-risk PE
- 24.1%
- Proportion of high-risk patients and mean Composite Pulmonary Embolism Score (CPES) increased over the study period
Original publication
Mechanical Thrombectomy and Catheter-Directed Thrombolysis in Acute Pulmonary Embolism. J Am Coll Cardiol. Published 25 February 2026. doi:10.1016/j.jacc.2025.12.073
Summarised from the published abstract; every number is checked against it