Evidence map›Paper›PMID 40754033›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2026

Short-term outcomes of thrombolysis versus surgical pulmonary embolectomy in patients with high-risk pulmonary embolism.

Keiichi Ishida, Yuji Nishimoto, Hiroyuki Ohbe, Nobutaka Ikeda, Toshihiko Sugiura, Rika Suda, Nobuhiro Tanabe, Makoto Mo, Yuya Kimura, Hiroki Matsui and 1 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Keiichi IshidaDepartment of Cardiac Surgery, International University of Health and Welfare, Narita, Japan.
Yuji NishimotoDepartment of Cardiology, Toyonaka Municipal Hospital, Toyonaka, Japan.
Hiroyuki OhbeDepartment of Emergency and Critical Care Medicine, Tohoku University Hospital, Sendai, Japan; Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan. Electronic address: hohbey@gmail.com.
Nobutaka IkedaDivision of Cardiovascular Medicine, Toho University Medical Center, Ohashi Hospital, Tokyo, Japan.
Toshihiko SugiuraDepartment of Respirology, Chiba University Graduate School of Medicine, Chiba, Japan.
Rika SudaDepartment of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan.
Nobuhiro TanabeDepartment of Respirology, Chibaken Saiseikai Narashino Hospital, Narashino, Japan.
Makoto MoJapanese Society of Phlebology, Tokyo, Namiki Clinic, Yokohama, Japan.
Yuya KimuraDepartment of Health Services Research, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Hiroki MatsuiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe survival benefit of thrombolysis compared with surgical pulmonary embolectomy for high-risk pulmonary embolism has not been established, although current guidelines advocate thrombolysis as first-line therapy. This study compared the short-term outcomes of surgical pulmonary embolectomy and thrombolysis to determine the optimal treatment for high-risk pulmonary embolism.

methodsPatients with high-risk pulmonary embolism who underwent surgical pulmonary embolectomy or thrombolysis within 2 days of admission were identified using a nationwide inpatient administrative database in Japan between July 2010 and March 2023. The primary outcome was in-hospital mortality, and secondary outcomes were complications, length of hospital stay, and total hospitalization costs. Outcomes were compared using overlap weighting, with sensitivity analyses conducted using inverse probability of treatment weighting and multivariate logistic regression model.

resultsOf the 2813 eligible patients, 526 underwent surgical pulmonary embolectomy, and 2287 underwent thrombolysis. After overlap weighting, surgical pulmonary embolectomy was associated with lower in-hospital mortality (22.2% vs 30.1%, P = .002), more favorable neurological outcomes at discharge (72.5% vs 66.7%, P = .040), and higher total costs ($30,548 vs $13,374, P < .001) than thrombolysis. No significant differences were observed in complications or length of hospital stay between the 2 groups. Sensitivity analyses yielded results consistent with the primary analyses.

conclusionsThese findings suggest potential benefits of surgical pulmonary embolectomy over thrombolysis for high-risk pulmonary embolism. Surgical pulmonary embolectomy may be considered a reasonable reperfusion therapy option for suitable patients. Further research is needed to confirm these findings.

Indexed as

EmbolectomyPulmonary EmbolismThrombolytic TherapyAgedAged, 80 and overDatabases, FactualFemaleHospital CostsHospital MortalityHumansJapanLength of StayMaleMiddle AgedRetrospective StudiesRisk Assessmentacute pulmonary embolismhigh-risk pulmonary embolismpulmonary embolectomythrombolysis

Identifiers

PMID40754033

What OpenQuestion holds

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Registered trials

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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.