Endovascular Therapy for Acute PE: SCAI/SIR Update on Ongoing and Completed RCTs-Panel: How Does PEERLESS Affect Our Practice?

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Video Summary

The discussion centers on a recent trial comparing catheter-directed thrombolysis and mechanical thrombectomy in treating pulmonary embolism (PE). Members of the panel commend the study for its execution despite the challenge of randomizing patients. This trial, published in a high-impact journal, aims to enhance scientific understanding in this field. Key takeaways include the effectiveness and comparable safety profiles of both treatment options, as shown by similar major bleeding rates. The trial results have opened discussions about the appropriateness of these interventions versus anticoagulation alone, particularly as endovascular treatment grows. While mechanical thrombectomy is heavily favored due to its efficacy and practical advantages, the role of thrombolysis remains, particularly for distal thrombus cases. Future research focusing on distinguishing these interventions' efficacy and application in guidelines is anticipated, especially for patients at higher risk or with intermediate-high risk PE.

Keywords

pulmonary embolism

mechanical thrombectomy

catheter-directed thrombolysis

endovascular treatment

randomized trial