Abstract Rationale The Pulmonary Embolism Response Team (PERT) is a multidisciplinary team designed to manage patients with acute pulmonary embolism (PE) at risk for decompensation. While this has been an area of considerable innovation, post-PE care is relatively underdiscussed — particularly the evaluation of persistent dyspnea and post-PE syndromes. Guidelines provide frameworks for follow-up, however, published data on post-PE surveillance and imaging remain limited. Most available studies are derived from large academic centers, which may not reflect practices at community-based tertiary care institutions. To address this gap, we conducted a retrospective study to quantify imaging rates, and findings at one and three months in patients treated with catheter-directed therapy (CDT) and/or systemic thrombolysis. Methods Adult (age ≥18 years) subjects from our PERT registry who underwent CDT and/or received systemic tPA from 3/1/2021 - 3/31/2025 were identified. Follow-up rates, imaging utilization and findings, were analyzed at one and three months. Results A total of 129 patients with acute PE requiring CDT and/or systemic tPA were identified. At one-month follow-up, 75 patients (58.1%) were evaluated, of whom 23 (30.7%) underwent repeat imaging. The most common modality was transthoracic echocardiography (TTE) in 15 subjects; 20.0% of those presented for follow-up. Among those with repeat TTE, 3 (20%) demonstrated residual right heart abnormalities; two were with right heart strain, and one with right ventricular dilation (Table 1). At 3-month follow-up, 62 subjects (48.1%) were seen. Cumulatively, 28 (45.2%) had a documented TTE. Among them, two showed persistent abnormalities, with one demonstrating right heart strain and RV dilation, and another showing septal flattening, right heart strain, and RV dilation (Table 1). Conclusions Follow-up post-CDT and/or systemic tPA for acute PE was suboptimal, reflecting fragmented care and the absence of standardized surveillance protocols. Our findings underscore potential disparities between resource-rich tertiary centers and smaller community-based tertiary centers, though further analyses are warranted. Prior studies have demonstrated the effectiveness of a multidisciplinary post-PE clinic in improving follow-up and facilitating systematic evaluation for post-PE syndromes within a large academic center. Current guideline statements provide only broad recommendations regarding imaging reassessment, leaving practice patterns highly variable across post-PE programs. Studies suggest that structured strategies, such as the SEARCH algorithm, may offer a practical framework for standardized follow-up and imaging. When applied across diverse settings, such approaches could enable earlier detection of post-PE syndromes, optimize resource utilization, and improve equity of care delivery—particularly in community tertiary centers. This abstract is funded by: None
Sheehan et al. (Fri,) studied this question.