Trial reportCirculation2025
Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial.
Trial report in Circulation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05111613 (The PEERLESS Study), which is not on this map. Cited by 84 papers, 1 of them a synthesis 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.
The PEERLESS Study
Who cites it
84 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mechanical Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: A Systematic Review and Meta-Analysis.Cardiovascular and interventional radiology · 2026Pooled it
- Effect of intensive blood pressure and blood glucose control on cardiovascular outcomes driven by reductions in cardiovascular death and nephropathy: win ratio analysis of ADVANCE trial.European heart journal. Cardiovascular pharmacotherapy · 2026Trial
- The 2026 pulmonary embolism guideline in a regional intensive care unit: Reading the recommendations without a catheter laboratory.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Subacute Pulmonary Embolism: Insights from a National Registry of Catheter-Directed Interventions.Journal of clinical medicine · 2026Article
- Safety profile and resource utilisation associated with systemic alteplase versus unfractionated heparin in intermediate-high risk pulmonary embolism: a prospective ICU cohort study.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Mechanical Thrombectomy Versus Systemic Thrombolysis in Hemodynamically Unstable High-Risk Pulmonary Embolism Requiring Vasopressors: A Propensity-Matched Outcomes Analysis From TriNetX Network.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- A Prospective, Randomized Controlled Trial of Intravascular Ultrasound-Guided versus Digital Subtraction Angiography-Guided Mechanical Thrombectomy in Acute Intermediate-Risk and High-Risk Pulmonary Embolism.Cardiovascular and interventional radiology · 2026Article
- Unplanned 6-month readmissions and in-hospital outcomes for the management of acute intermediate- and high-risk pulmonary embolism: comparisons of endovascular interventions.CVIR endovascular · 2026Article
- Mechanical thrombectomy in cancer-associated pulmonary embolism: reassuring safety, unclear benefit.Research and practice in thrombosis and haemostasis · 2026Article
- Acute Pulmonary Embolism: Refining the Risk-Benefit Paradigm in Contemporary Venous Thromboembolism Intervention.Cardiovascular and interventional radiology · 2026Article
- Catheter-Based Therapies for Intermediate-High Risk Pulmonary Embolism: A Protocol for a Systematic Review With Bayesian Pairwise and Network Meta-Analyses.Acta anaesthesiologica Scandinavica · 2026Review
- Interventional Mechanical Thrombectomy for Limb Salvage in Rapidly Progressive Phlegmasia Cerulea Dolens.Clinical case reports · 2026Article
- Mechanical Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: A Risk-Stratified, Propensity Score-Matched Analysis.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Percutaneous mechanical thrombectomy using the AcoStream thrombus aspiration system for intermediate-high-risk pulmonary embolism.Journal of thoracic disease · 2026Article
- Aspirated thrombus weight and volume are not associated with improvements in hemodynamics after large-bore mechanical thrombectomy in pulmonary embolism.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Initial management of intermediate- and high-risk pulmonary embolism.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Review
- Outcomes of catheter-directed mechanical thrombectomy in patients with cancer-associated pulmonary embolism: a multicenter, prospective registry.Research and practice in thrombosis and haemostasis · 2026Observational
- Effects of Early Versus Delayed Mechanical Thrombectomy on Outcomes in Intermediate-Risk Acute Pulmonary Embolism.Critical care medicine · 2026Article
- Ultrasound-Mediated Thrombolysis: From Mechanistic Insights to Advanced Nanoplatforms and Clinical Translation.Advanced healthcare materials · 2026Review
- How patient profile and hospital setting drive pulmonary embolism treatment modality.Journal of vascular surgery. Venous and lymphatic disorders · 2026Article
24 more citing papers are in PubMed but not listed here.
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Authors and funding
41 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are a lack of randomized controlled trial data comparing outcomes of different catheter-based interventions for intermediate-risk pulmonary embolism.
methodsPEERLESS is a prospective, multicenter, randomized controlled trial that enrolled 550 patients with intermediate-risk pulmonary embolism with right ventricular dilatation and additional clinical risk factors randomized 1:1 to treatment with large-bore mechanical thrombectomy (LBMT) or catheter-directed thrombolysis (CDT). The primary end point was a hierarchal win ratio composite of the following (assessed at the sooner of hospital discharge or 7 days after the procedure): (1) all-cause mortality, (2) intracranial hemorrhage, (3) major bleeding, (4) clinical deterioration and/or escalation to bailout, and (5) postprocedural intensive care unit admission and length of stay. Assessments at the 24-hour visit included respiratory rate, modified Medical Research Council dyspnea score, New York Heart Association classification, right ventricle/left ventricle ratio reduction, and right ventricular function. End points through 30 days included total hospital stay, all-cause readmission, and all-cause mortality.
resultsThe primary end point occurred significantly less frequently with LBMT compared with CDT (win ratio, 5.01 [95% CI, 3.68-6.97];
conclusionsPEERLESS met its primary end point in favor of LBMT compared with CDT in treatment of intermediate-risk pulmonary embolism. LBMT had lower rates of clinical deterioration and/or bailout and postprocedural intensive care unit use compared with CDT, with no difference in mortality or bleeding. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05111613.
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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.