ArticleJournal of vascular surgery. Venous and lymphatic disorders2018
Catheter-directed interventions compared with systemic thrombolysis achieve improved ventricular function recovery at a potentially lower complication rate for acute pulmonary embolism.
Article in Journal of vascular surgery. Venous and lymphatic disorders, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: systematic review and network meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Pooled it
- Catheter directed compared to systemically delivered thrombolysis for pulmonary embolism: a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2022Pooled it
- One-Year Echocardiographic, Functional, and Quality of Life Outcomes After Ultrasound-Facilitated Catheter-Based Fibrinolysis for Pulmonary Embolism.Circulation. Cardiovascular interventions · 2020Trial
- Comparative effectiveness of suction thrombectomy versus catheter-directed thrombolysis in intermediate-risk pulmonary embolism.Journal of vascular surgery · 2025Article
- Catheter-Based Therapies in Acute Pulmonary Embolism-Mortality and Safety Outcomes: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Acute pulmonary embolism following dual-chamber pacemaker implantation: a case report.Frontiers in cardiovascular medicine · 2025Article
- Outcomes in High-Risk Pulmonary Embolism Patients Undergoing FlowTriever Mechanical Thrombectomy or Other Contemporary Therapies: Results From the FLAME Study.Circulation. Cardiovascular interventions · 2023Article
- Outcomes of catheter-directed thrombolysis versus systemic thrombolysis in the treatment of pulmonary embolism: a meta-analysis.Journal of geriatric cardiology : JGC · 2023Article
- Percutaneous Management of High-Risk Pulmonary Embolism.Circulation. Cardiovascular interventions · 2023Review
- The safety and efficacy of systemic versus catheter-based therapies: application of a prognostic model by a pulmonary embolism response team.Journal of thrombosis and thrombolysis · 2022Article
- Article
- Catheter-Directed Therapies in Patients with Pulmonary Embolism: Predictive Factors of In-Hospital Mortality and Long-Term Follow-Up.Journal of clinical medicine · 2021Article
- Association Between Black Race, Clinical Severity, and Management of Acute Pulmonary Embolism: A Retrospective Cohort Study.Journal of the American Heart Association · 2021Article
- Is there an optimal "door to cath time" in the treatment of acute pulmonary embolism with catheter-directed thrombolysis?Annals of translational medicine · 2019Review
- Incidence of Mortality and Complications in High-Risk Pulmonary Embolism: A Systematic Review and Meta-Analysis.Journal of the Society for Cardiovascular Angiography & InterventionsReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveCatheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis (ST) while decreasing the associated complications. The purpose of this study was to compare outcomes between CDI and ST.
methodsConsecutive patients who underwent CDIs or ST for massive or submassive PE between 2006 and 2016 were identified. Clinical and echocardiographic parameters at baseline and after treatment were recorded. Clinical success was defined as decompensation resolution (or prevention) without major bleeding, stroke, other major treatment-related event, or in-hospital death. The χ
resultsThere were 213 patients who received CDIs (standard catheter thrombolysis in 56, ultrasound-assisted thrombolysis in 146, suction thrombectomies in 10, and pharmacomechanical thrombolysis in 1) and 104 patients who received ST (94 high dose [100 mg], 10 low dose [50 mg]). At baseline, CDI and ST groups had comparable echocardiographic parameters, demographics, and comorbidities, except for PE type (massive PE, 8.5% for CDIs vs 69.2% for ST; P < .001), age (60.2 ± 14.9 years for CDIs vs 55.9 ± 17.3 years for ST; P = .023), and renal function (glomerular filtration rate, 78.1 ± 33.7 mL/min/1.73 m
conclusionsCDIs provide improved recovery of right ventricular function compared with ST. Major bleeding and stroke complications may be lower, but larger studies are needed to validate this. CDIs are complementary to ST, and their use should be individualized on the basis of the patients' clinical presentation, risk profile, and local resources.
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