Catheter-directed interventions in acute pulmonary embolism treatment

Abstract

Abstract: Catheter-based interventions for acute pulmonary embolism (PE) have evolved over the past decades to achieve the benefits of systemic thrombolysis, avoiding though its systemic complications and offering a therapeutic option to a wider spectrum of PE patients who may be contraindicated for thrombolytics. Although numerous observational, retrospective, or small prospective studies have been performed to evaluate the myriad devices used in the preceding years, few are of adequate quality to support widespread use. However, we were seeing an increasing use of catheter thrombolytic and aspiration thrombectomy procedures in both US and Europe. Evidence is building up through several industry trials, and more recently, the PE-Thrombus Removal with Adjunctive Catheter-directed Therapy randomized National Institutes of Health-funded trial was approved to evaluate their benefit over anticoagulation alone in intermediate risk patients. The current evolution of these techniques and existing evidence for their use are summarized.