F-32 | The Efficacy and Safety of Catheter-Directed Interventions for Acute PE in patients with underlying Liver Cirrhosis: A Propensity Matched Nationwide Analysis

Catheter Directed Interventions (CDIs) for Pulmonary Embolism have been present for years but their use has been limited due to paucity of data. We aim to compare these interventions in patients with and without liver cirrhosis. The National Readmission Database (2016-2020) was utilized to identify CDIs (thrombectomy & thrombolysis) for acute pulmonary embolism (PE) with cor pulmonale. Cohorts were stratified based on Liver Cirrhosis. A Propensity Score Matching (PSM) model, matched cirrhotics & non-cirrhotics. Pearson's x2 test was applied to the PSM-2 matched cohorts to compare outcomes. Among 51,672 CDIs for PEs, the majority were in non-cirrhotics (N= 50198, 97.1%), whereas only 1474 interventions (2.9%) were in cirrhotics. After propensity matching (N 778), cirrhotic patients were found to have higher adverse events, including mortality (40.9% vs 27.8%, p <0.001), cardiogenic shock (39.5% vs 7.1%, p <0.001), SCA (28.9% vs 7.5%), respiratory failure (41.1% vs 8.6%), need for vasopressors (15.8% vs 4%), AKI (75.4% vs 25.2%), acute bleeding (31.5% vs 11.6%), GI bleeding (10.9% vs 1.4%, aOR:5.78), Thoracic/Respiratory bleeding (6.7% vs 2.4%), need for transfusion (88% vs 42.9%) & intracerebral hemorrhage ( aOR:2.05) [p<0.01]. LOS was also found to be higher in cirrhotics (Median LOS: 10 vs 3 days) compared to non-cirrhotics (p<0.001). Acute PE with Cor pulmonale undergoing CDIs was associated with higher mortality and adverse outcomes in patients with liver cirrhosis. The presence of liver dysfunction was associated with higher rates of CDI-related bleeding compared to non-cirrhotics.