ArticleInterdisciplinary cardiovascular and thoracic surgery2026
Outcomes of EKOS (Ultrasound-Assisted Thrombolysis) for Intermediate-High-Risk Pulmonary Embolism: A PERT-Guided Cohort Study.
Article in Interdisciplinary cardiovascular and thoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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12 authors.
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Abstract
objectivesAcute intermediate-high-risk pulmonary embolism (PE) is associated with right-ventricular (RV) dysfunction, biomarker elevation, and risk of early clinical deterioration. Ultrasound-assisted catheter-directed thrombolysis (USAT) using the Eko Sonic Endovascular System (EKOS) system is increasingly used in selected patients; however, real-world data on physiological response and clinically relevant in-hospital outcomes remain limited.
methodsWe conducted a retrospective single-centre analysis of 128 consecutive patients with acute intermediate-high-risk PE treated with EKOS-guided USAT within a structured Pulmonary Embolism Response Team (PERT) pathway between August 2017 and December 2023. Changes in RV/LV ratio, B-type natriuretic peptide (BNP), and cardiac troponin before and after intervention were assessed. A composite end-point of death, extracorporeal membrane oxygenation (ECMO), renal replacement therapy, or invasive mechanical ventilation captured clinically meaningful deterioration. Multivariable logistic regression identified determinants of the composite end-point.
resultsRV/LV ratio and biomarkers improved significantly after intervention. Median RV/LV ratio decreased from 1.6 to 1.0, and BNP declined from 2365 to 877 pg/mL (both P < .001). Clinically meaningful in-hospital deterioration requiring escalation of organ support occurred in a subset of patients and was predominantly associated with baseline disease severity. Short-term survival remained favourable (60-day probability 96.9%).
conclusionsIn this real-world, PERT-guided cohort, EKOS was associated with rapid physiological improvement and favourable short-term survival in patients with intermediate-high-risk PE. These findings should be interpreted as descriptive single-centre experience.
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