Endovascular Therapy for Acute PE: SCAI/SIR Update on Ongoing and Completed RCTs-Key Findings from the PEERLESS Trial

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Video Summary

The Peerless trial addresses the need for a comparative study between catheter-directed thrombolysis and large-form mechanical thrombectomy for pulmonary embolism (PE). The trial enrolled 550 intermediate-risk PE patients and used a unique Winn ratio to assess outcomes like mortality and intracranial hemorrhage. While thrombolysis had a longer ICU stay, mechanical thrombectomy showed a significant endpoint win ratio, favoring it with fewer clinical deterioration incidents. By 30 days, early advantages in symptom relief of thrombectomy were no longer evident. The trial highlights the efficacy and safety of both interventions, particularly in a low bleeding risk population.

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Jay Giri, MD, MPH, FSCAI

Keywords

Peerless trial

pulmonary embolism

mechanical thrombectomy

catheter-directed thrombolysis

Winn ratio