Key result
Ultrasound-assisted catheter-directed thrombolysis resulted in significant clinical and echocardiographic improvements, including normalization of right ventricular function, in three patients with high-risk and intermediate-high-risk pulmonary embolism without major bleeding complications.
Why the study?
Systemic thrombolysis for pulmonary embolism carries a substantial bleeding risk, leading to interest in ultrasound-assisted catheter-directed thrombolysis as an alternative to enhance clot resolution while minimizing hemorrhagic complications.
Case Report (n=3)
No
In a small case series, ultrasound-assisted catheter-directed thrombolysis improved clinical and echocardiographic parameters in high-risk and intermediate-high-risk pulmonary embolism patients without causing major bleeding.
UCDT feasible in high-risk PE cases; hypothesis-generating and should not change practice without RCTs.
Pulmonary embolism (PE) is a life-threatening condition associated with significant morbidity and mortality. While systemic thrombolysis is effective in high-risk cases, it carries a substantial risk of bleeding complications. Ultrasound-assisted catheter-directed thrombolysis (UCDT) has emerged as a promising alternative, enhancing clot resolution while minimizing hemorrhagic risks. This case series presents three patients with high-risk and intermediate-high-risk PE who underwent UCDT. All patients exhibited hemodynamic instability and right ventricular dysfunction. Following UCDT, significant clinical and echocardiographic improvements were observed, with no major bleeding complications. UCDT represents a targeted thrombolysis approach that optimizes clot dissolution while reducing systemic thrombolytic exposure. Current evidence supports UCDT as an effective and safer alternative for select PE patients, though further randomized studies are needed to refine patient selection and standardize treatment protocols. This case series highlights the clinical benefits of UCDT and reinforces its role as a viable treatment strategy.
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Aboaly et al. (2025) conducted a case report in Pulmonary embolism (n=3). Ultrasound-assisted catheter-directed thrombolysis was evaluated on Clinical and echocardiographic improvement. Ultrasound-assisted catheter-directed thrombolysis resulted in significant clinical and echocardiographic improvements, including normalization of right ventricular function, in three patients with high-risk and intermediate-high-risk pulmonary embolism without major bleeding complications.
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