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March 3, 2026Pulmonary CirculationOpen Access

At 48 h, the RV/LV ratio decreased by 0.3 (95% CI: 0.13-0.69; p < 0.0002) in the thrombectomy group and by 0.4 (95% CI: 0.12-0.96; p < 0.0002) in the thrombolysis group, though at 1 to 12 months follow-up, all three groups showed similar improvements.

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Why the study?

The optimal treatment strategy for patients with acute intermediate-high-risk pulmonary embolism remains uncertain.

Do percutaneous reperfusion therapies improve echocardiographic and hemodynamic parameters in patients with acute intermediate-high-risk pulmonary embolism compared to anticoagulation alone?

Population

39 patients with acute intermediate-high-risk PE

Comparison

Trans-catheter thrombectomy vs trans-catheter thrombolysis vs conservative medical therapy with anticoagulation

Design

Single-center prospective 1:1:1 randomized clinical trial

Follow-up

12-month

Authors

TITaida IvanauskienėVilnius UniversityABAndrius BerūkštisVilnius UniversityGBGreta BurneikaitėVilnius University

Discussion

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Overview

Offers faster early RV recovery vs anticoagulation in intermediate-high-risk PE; leaves open long-term clinical benefit.

Key Points

  • Functional capacity and quality of life were better in interventional groups than with anticoagulation alone, indicating improved treatment outcomes.
  • At 48 hours, significant RV function and pulmonary pressure improvements were seen in both interventional groups, with p-values less than 0.001.
  • Observational analysis revealed echocardiographic and biomarker changes were similar across treatment groups at 1-year follow-up, emphasizing treatment stability.
  • Thrombolysis reported a higher incidence of adverse events (38%) compared to thrombectomy and anticoagulation, suggesting different safety profiles.

Structured PICO

Do percutaneous reperfusion therapies improve echocardiographic and hemodynamic parameters in patients with acute intermediate-high-risk pulmonary embolism compared to anticoagulation alone?

P
Population
39 patients with acute intermediate-high-risk pulmonary embolism (PE)
I
Intervention
Trans-catheter thrombectomy or trans-catheter thrombolysis
C
Comparator
Conservative medical therapy with anticoagulation
O
Outcome
Echocardiographic, hemodynamic, and biomarker parameters at 48 h, and at 1-, 6-, and 12-month follow-upsurrogate

In acute intermediate-high-risk PE, percutaneous reperfusion therapies accelerate early hemodynamic and RV function recovery compared to anticoagulation alone, but yield similar long-term echocardiographic outcomes.

Limitations

  • Single-center
  • Mechanistic and hypothesis-generating

Cite This Study

Ivanauskienė et al. (2026) studied this question.

synapsesocial.com/papers/69a75b6cc6e9836116a22b58https://doi.org/10.1002/pul2.70249
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Efficacy of transcatheter low-dose thrombolysis in patients with intermediate-high risk pulmonary embolism. Study rationale and design2025 · 1 citations
  2. 2A pilot randomised trial of catheter-directed thrombolysis or standard anticoagulation for patients with intermediate-high risk acute pulmonary embolism2022 · 51 citations
  3. 3Immediate and late impact of reperfusion therapies in acute pulmonary embolism2019 · 19 citations
  4. 4Reperfusion therapies in patients with intermediate- and high-risk pulmonary embolism: insights from a multicenter registry2024 · 3 citations
  5. 5Assessment of lytic therapy effect in patients with intermediate‐high risk pulmonary embolism for prevention of chronic thromboembolic pulmonary hypertension: A randomized, double‐blind trial2024