Management of Pulmonary Embolism With Thrombus in Transit: A Case Series and an Updated Clinical Insight Review.

Clot-in-transit (CIT) refers to a thrombus temporarily lodged in the right heart chambers, representing a critical and rare complication of venous thromboembolism, particularly in patients with acute pulmonary embolism (PE). This condition poses a significant risk of morbidity and mortality. This report provides a comprehensive overview of CIT in the context of PE, focusing on its definition, etiopathogenesis, risk classification, clinical manifestations, imaging findings, and treatment options. A retrospective review of CIT cases in PE patients at our institution was conducted, complemented by a detailed literature review. Data were analyzed to highlight the clinical findings, imaging results, and diverse treatment strategies employed. Five cases of CIT associated with PE are presented, illustrating varied risk factors, clinical presentations, and imaging findings. Treatment modalities included anticoagulation, thrombolysis, and surgical thrombectomy. Each case underscores the diagnostic challenges and management complexities inherent to CIT. CIT is a life-threatening complication of pulmonary thromboembolism. Early identification and individualized treatment are essential for improving outcomes. This case series provides valuable insights into CIT management and emphasizes the importance of multidisciplinary approaches for optimal patient care.