Key result
Mechanical thrombectomy offers an alternative for high-risk PE in patients aged >75 years.
Why the study?
Advanced age, specifically more than 75 years of age, is considered a relative contraindication for systemic lysis in pulmonary embolism, motivating evaluation of mechanical thrombectomy outcomes in older patients.
Systemic lysis safety in elderly intermediate-risk PE remains uncertain; leaves open need for targeted trials before broader adoption.
Patients with intermediate-risk pulmonary embolism (PE) are defined as being hemodynamically stable, but with imaging and laboratory evidence of right ventricular (RV) dysfunction.1 In comparison, patients with high-risk PE are defined as being hemodynamically unstable. Systemic lysis has been established as a modality of treatment in high-risk PE. However, advanced age, specifically more than 75 years of age, has been labeled as a relative contraindication for systemic lysis.2 Systemic lysis has also been studied in the intermediate-risk PE patient population.
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Nasser et al. (2026) conducted an editorial in Pulmonary embolism. Mechanical thrombectomy vs. Systemic lysis was evaluated. Systemic lysis is an established treatment for high-risk pulmonary embolism, though age >75 years is considered a relative contraindication, prompting interest in mechanical thrombectomy.
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