Catheter Interventions for Pulmonary Embolism: Mechanical Thrombectomy Versus Thrombolytics

Methodist Debakey Cardiovasc J. 2024 May 16;20(3):36-48. doi: 10.14797/mdcvj.1344. eCollection 2024.

Abstract

Pulmonary embolism is a debilitating and potentially life-threatening disease characterized by high mortality and long-term adverse outcomes. Traditional treatment options are fraught with serious bleeding risks and incomplete thrombus removal, necessitating the development of innovative treatment strategies. While new interventional approaches offer promising potential for improved outcomes with fewer serious complications, their rapid development and need for more comparative clinical evidence makes it challenging for physicians to select the optimal treatment for each patient among the many options. This review summarizes the current published clinical data for both traditional treatments and more recent interventional approaches indicated for pulmonary embolism. While published studies thus far suggest that these newer interventional devices offer safe and effective options, more data is needed to understand their impact relative to the standard of care. The studies in progress that are anticipated to provide needed evidence are reviewed here since they will be critical for helping physicians make informed treatment choices and potentially driving necessary guideline changes.

Keywords: PE; mechanical thrombectomy; pulmonary embolism; thrombolytics.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Clinical Decision-Making
  • Equipment Design
  • Fibrinolytic Agents* / administration & dosage
  • Fibrinolytic Agents* / adverse effects
  • Humans
  • Pulmonary Embolism* / diagnostic imaging
  • Pulmonary Embolism* / mortality
  • Pulmonary Embolism* / therapy
  • Risk Factors
  • Thrombectomy* / adverse effects
  • Thrombectomy* / instrumentation
  • Thrombolytic Therapy* / adverse effects
  • Treatment Outcome