Key result
Catheter-directed thrombolysis achieved the primary efficacy composite endpoint more frequently than standard anticoagulation in intermediate-high risk acute PE (58.3% vs 9.1%, p=0.0004).
Why the study?
Intermediate-high risk acute pulmonary embolism remains associated with substantial mortality despite anticoagulation therapy.
Does catheter-directed thrombolysis improve right ventricular function, decrease pulmonary pressure, and reduce thrombus burden compared to standard anticoagulation in patients with intermediate-high risk acute pulmonary embolism?
Comparison
Catheter-directed thrombolysis vs standard anticoagulation
Design
Randomised pilot study
Authors
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Supports CDT over anticoagulation for intermediate-high risk PE; challenges prior evidence against thrombolysis.
RCT (n=23)
1:1
No
Does catheter-directed thrombolysis improve right ventricular function, decrease pulmonary pressure, and reduce thrombus burden compared to standard anticoagulation in patients with intermediate-high risk acute pulmonary embolism?
Absolute Event Rate: 58.3% vs 9.1%
p-value: p=0.0004
Catheter-directed thrombolysis with alteplase significantly improved surrogate markers of right ventricular function and pulmonary pressure compared to standard anticoagulation in intermediate-high risk acute pulmonary embolism.
Kroupa et al. (2022) conducted an RCT in Intermediate-high risk acute pulmonary embolism (n=23). Catheter-directed thrombolysis vs. Standard anticoagulation was evaluated on Improvement of right ventricular (RV) function, a decrease in pulmonary pressure, and a reduction of thrombus burden (p=0.0004). Catheter-directed thrombolysis achieved the primary efficacy composite endpoint more frequently than standard anticoagulation in intermediate-high risk acute PE (58.3% vs 9.1%, p=0.0004).
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