Why the study?
Advanced endovascular therapies are increasingly used for pulmonary embolism, but high-quality head-to-head comparative safety data between devices frequently used in clinical practice are lacking.
Does mechanical thrombectomy improve clinical outcomes or safety compared to ultrasound-assisted catheter-directed thrombolysis in patients with pulmonary embolism?
Population
2259 patients with PE treated with USCDT or MT
Comparison
USCDT vs MT
Design
Retrospective electronic health record-based platform analysis
Follow-up
30 days
Key result
Mechanical thrombectomy for pulmonary embolism was associated with a higher risk of ISTH-modeled major bleeding compared to USCDT (15.4% vs 11.8%; OR 1.37; 95% CI 1.10-1.74; P<0.001).
Authors
Loading...
Mechanical thrombectomy's higher bleeding risk warrants caution versus USCDT; leaves open whether randomized trials will confirm observational differences in pulmonary embolism.
Does mechanical thrombectomy improve clinical outcomes or safety compared to ultrasound-assisted catheter-directed thrombolysis in patients with pulmonary embolism?
Effect estimate: OR 1.37 (95% CI 1.10-1.74)
Absolute Event Rate: 15.4% vs 11.8%
p-value: p=<0.001
In a real-world analysis, mechanical thrombectomy for pulmonary embolism showed similar short-term mortality to ultrasound-assisted catheter-directed thrombolysis but was associated with higher rates of major bleeding and intracranial hemorrhage, though unmeasured confounding may exist.
Ortega-Paz et al. (2023) conducted an editorial in Pulmonary embolism (n=2,259). Mechanical thrombectomy (MT) vs. Ultrasound-assisted catheter-directed thrombolysis (USCDT) was evaluated on ISTH-modeled major bleeding (OR 1.37, 95% CI 1.10-1.74, p=<0.001). Mechanical thrombectomy for pulmonary embolism was associated with a higher risk of ISTH-modeled major bleeding compared to USCDT (15.4% vs 11.8%; OR 1.37; 95% CI 1.10-1.74; P<0.001).