ArticleFrontiers in cardiovascular medicine2026
Detected residual venous thrombi and catheter-directed management of intermediate-risk pulmonary thromboembolism.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Retained clots leading to recurrent episodes of thromboembolism are a major cause of early mortality post PE, that may reach 17% within 3 months after the first episode. The use of catheter-directed interventions in the management of pulmonary embolism is currently restricted to hemodynamically unstable patients and to those classified as intermediate-high risk individuals, based on cardiac echo and troponin. Current guidelines do not recommend these strategies in patients classified as intermediate-low risk (i.e., evidence of RV compromise by echo but without elevated troponin). We propose a mandatory evaluation of the presence or absence of retained clots within great veins, particularly in this subset of patients, since detecting retained large ileo-femoral thrombi (that are identified in some 50% of patients) may affect treatment decisions, favoring catheter-directed interventions, as relieved RV afterload may enable coping with repeated PE episodes. Our hypothesis requires validation in prospective clinical trials.
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