ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2023
Comparison of interventions for intermediate to high-risk pulmonary embolism: A network meta-analysis.
Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Mechanical Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: A Systematic Review and Meta-Analysis.Cardiovascular and interventional radiology · 2026Pooled it
- Current Insights for Catheter-Directed Therapies in Acute Pulmonary Embolism: Systematic Review and Our Single-Center Experience.Anatolian journal of cardiology · 2023Pooled it
- Percutaneous mechanical thrombectomy using the AcoStream thrombus aspiration system for intermediate-high-risk pulmonary embolism.Journal of thoracic disease · 2026Article
- Role of ECMO and percutaneous mechanical thrombectomy in the management of acute pulmonary embolism.Frontiers in cardiovascular medicine · 2026Review
- Surgical Pulmonary Embolectomy Versus Systemic Thrombolysis in High-Risk Pulmonary Embolism: A Retrospective Single-Center Analysis.Journal of clinical medicine · 2025Article
- A comparative study of anticoagulation combined with different catheter-directed thrombolysis strategies (urokinase catheter-directed vs. alteplase infusion) in the treatment of intermediate-risk pulmonary embolism.Frontiers in cardiovascular medicine · 2025Article
- Research progress in interventional therapy for acute intermediate-high-risk and high-risk pulmonary embolism.Journal of thoracic disease · 2024Review
- Risk Factors and Outcomes of Acute Pulmonary Embolism in African Patients: A Systematic Review.Cureus · 2024Review
- Clinical Outcome Using Different Catheter Interventional Treatment Modalities in High-Risk Pulmonary Artery Embolism.Journal of cardiovascular development and disease · 2024Article
Corrections and comments
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Authors and funding
10 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundMultiple interventions, including catheter-directed therapy (CDT), systemic thrombolysis (ST), surgical embolectomy (SE), and therapeutic anticoagulation (AC) have been used to treat intermediate to high-risk pulmonary embolism (PE), but the most effective and safest treatment remains unclear. Our study aimed to investigate the efficacy and safety outcomes of each intervention.
methodsWe queried PubMed and EMBASE in January 2023 and performed a network meta-analysis of observational studies and randomized controlled trials (RCT), including high or intermediate-risk PE patients, and comparing AC, CDT, SE, and ST. The primary outcomes were in-hospital mortality and major bleeding. The secondary outcomes included long-term mortality (≥6 months), recurrent PE, minor bleeding, and intracranial hemorrhage.
resultsWe identified 11 RCTs and 42 observational studies involving 157,454 patients. CDT was associated with lower in-hospital mortality than ST (odds ratio [OR] [95% confidence interval (CI)]: 0.41 [0.31-0.55]), AC (OR [95% CI]: 0.33 [0.20-0.53]), and SE (OR [95% CI]: 0.61 [0.39-0.96]). Recurrent PE in CDT was lower than ST (OR [95% CI]: 0.66 [0.50-0.87]), AC (OR [95% CI]: 0.36 [0.20-0.66]), and trended lower than SE (OR [95% CI]: 0.71 [0.40-1.26]). Notably, ST had higher major bleeding risks than CDT (OR [95% CI]: 1.51 [1.19-1.91]) and AC (OR [95% CI]: 2.21 [1.53-3.19]). By rankogram analysis, CDT presented the highest p-score in in-hospital mortality, long-term mortality, and recurrent PE.
conclusionIn this network meta-analysis of observational studies and RCTs involving patients with intermediate to high-risk PE, CDT was associated with improved mortality outcomes compared to other therapies, without significant additional bleeding risk.
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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.