Trial reportJACC. Cardiovascular interventions2021
Randomized Trial Comparing Standard Versus Ultrasound-Assisted Thrombolysis for Submassive Pulmonary Embolism: The SUNSET sPE Trial.
Trial report in JACC. Cardiovascular interventions, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05493163 (A Multicentre, Randomized Trial of Catheter-directed Thrombolysis in Intermediate-high Risk Acute Pulmonary Embolism), which is not on this map. Cited by 99 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
A Multicentre, Randomized Trial of Catheter-directed Thrombolysis in Intermediate-high Risk Acute Pulmonary Embolism (PRAGUE-26)
Who cites it
99 citing papers in PubMed, 5 syntheses or guidelines pooled it, 176 citations in OpenAlex.
- Efficacy and safety of low-dose thrombolysis in intermediate-risk pulmonary embolism: a meta-analysis.Frontiers in cardiovascular medicine · 2026Pooled it
- Comparison of safety and efficacy of ultrasound-accelerated thrombolysis vs. standard catheter-directed thrombolysis for the management of acute pulmonary embolism - a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2025Pooled it
- Current Insights for Catheter-Directed Therapies in Acute Pulmonary Embolism: Systematic Review and Our Single-Center Experience.Anatolian journal of cardiology · 2023Pooled it
- Mortality and bleeding associated with the management of sub-massive pulmonary embolism: a systematic review and Bayesian network meta-analysis.Scientific reports · 2023Pooled it
- Catheter-directed therapies for the treatment of high risk (massive) and intermediate risk (submassive) acute pulmonary embolism.The Cochrane database of systematic reviews · 2022Pooled it
- Percutaneous mechanical thrombectomy using the AcoStream thrombus aspiration system for intermediate-high-risk pulmonary embolism.Journal of thoracic disease · 2026Article
- Ultrasound-Mediated Thrombolysis: From Mechanistic Insights to Advanced Nanoplatforms and Clinical Translation.Advanced healthcare materials · 2026Review
- Short-term outcomes of ultrasound-assisted catheter-directed thrombolysis and mechanical thrombectomy in management of intermediate-risk pulmonary embolism.Journal of vascular surgery. Venous and lymphatic disorders · 2026Article
- Interventional Management of Intermediate-High-Risk Pulmonary Embolism: Current Evidence, Patient Selection and Personalised Treatment Strategies.Journal of clinical medicine · 2026Review
- Long-Term Outcomes After Catheter-Directed Thrombolysis or Mechanical Thrombectomy in Intermediate-High-Risk Pulmonary Embolism: A Propensity-Matched Analysis From a TriNetX Database.Pulmonary circulation · 2026Article
- Outcomes of catheter intervention for acute pulmonary emboli in a tertiary United Kingdom centre with an established Pulmonary Embolism Response Team (PERT).CVIR endovascular · 2026Article
- Imaging-Driven Risk Stratification and Endovascular Decision Pathways in Acute Pulmonary Embolism.Diagnostics (Basel, Switzerland) · 2026Review
- Enhancing thrombolytic therapy in Japan-dwelling Japanese using clinical ultrasound with microbubble contrast agent.Journal of medical ultrasonics (2001) · 2026Article
- Comparison of short-term changes in right ventricular function after catheter-directed thrombolysis-based therapyJournal of thoracic disease · 2026Article
- Optimizing Care in Pulmonary Embolism with the Pulmonary Embolism Response Team.Current cardiology reports · 2026Review
- Reply: Management of Transcatheter Pulmonary Valve Thrombosis With Low-Dose, Slow-Infusion Fibrinolytic Therapy.JACC. Case reports · 2026Article
- Intraprocedural Management of Pulmonary Embolism Patients Undergoing Transcatheter Treatment, and Ventilatory and Cardiac Support.Interventional cardiology (London, England) · 2026Review
- Safety of ultrasound-assisted catheter-directed thrombolysis for central pulmonary embolism in intermediate-high-risk patients with increased bleeding risk in a rural hospital setting.Cardiology journal · 2026Article
- Association of advanced therapies for intermediate- to high-risk pulmonary embolism with improved right ventricular function on outpatient follow-up among survivors.Frontiers in cardiovascular medicine · 2026Article
- Association of transfer time and delays with outcomes for patients with acute pulmonary embolism requiring interhospital transfer: a retrospective observational study.Annals of medicine · 2025Observational
39 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2021
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesThe aim of this trial was to determine whether ultrasound-assisted thrombolysis (USAT) is superior to standard catheter-directed thrombolysis (SCDT) in pulmonary arterial thrombus reduction for patients with submassive pulmonary embolism (sPE).
backgroundCatheter-directed therapy has been increasingly used in sPE and massive pulmonary embolism as a decompensation prevention and potentially lifesaving procedure. It is unproved whether USAT is superior to SCDT using traditional multiple-side-hole catheters in the treatment of patients with pulmonary embolism.
methodsAdults with sPE were enrolled. Participants were randomized 1:1 to USAT or SCDT. The primary outcome was 48-hour clearance of pulmonary thrombus assessed by pre- and postprocedural computed tomographic angiography using a refined Miller score. Secondary outcomes included improvement in right ventricular-to-left ventricular ratio, intensive care unit and hospital stay, bleeding, and adverse events up to 90 days.
resultsEighty-one patients with acute sPE were randomized and were available for analysis. The mean total dose of alteplase for USAT was 19 ± 7 mg and for SCDT was 18 ± 7 mg (P = 0.53), infused over 14 ± 6 and 14 ± 5 hours, respectively (P = 0.99). In the USAT group, the mean raw pulmonary arterial thrombus score was reduced from 31 ± 4 at baseline to 22 ± 7 (P < 0.001). In the SCDT group, the score was reduced from 33 ± 4 to 23 ± 7 (P < 0.001). There was no significant difference in mean thrombus score reduction between the 2 groups (P = 0.76). The mean reduction in right ventricular/left ventricular ratio from baseline (1.54 ± 0.30 for USAT, 1.69 ± 0.44 for SCDT) to 48 hours was 0.37 ± 0.34 in the USAT group and 0.59 ± 0.42 in the SCDT group (P = 0.01). Major bleeding (1 stroke and 1 vaginal bleed requiring transfusion) occurred in 2 patients, both in the USAT group.
conclusionsIn the SUNSET sPE (Standard vs. Ultrasound-Assisted Catheter Thrombolysis for Submassive Pulmonary Embolism) trial, patients undergoing USAT had similar pulmonary arterial thrombus reduction compared with those undergoing SCDT, using comparable mean lytic doses and durations of lysis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.