Reperfusion Treatment in Acute Pulmonary Embolism

International guidelines recommend immediate reperfusion with systemic thrombolysis (ST) as first-line treatment in high-risk pulmonary embolism (PE). The therapy improves hemodynamics and overall survival but is also associated with a significant risk of severe bleeding. Catheter-directed intervention (CDI) is recommended as an alternative reperfusion therapy in high-risk PE when ST is contraindicated or has failed, as well as in patients who deteriorate or fail to improve during anticoagulation (AC) treatment. Despite lack of high-quality evidence and randomized studies between CDI and standard care, the use of CDI is spreading rapidly in high-risk PE and in less severe PE not fulfilling current treatment criteria.

NCT Number	NCT07003646
Lead Sponsor	Sahlgrenska University Hospital Collaborators: Stockholm South General Hospital, Karolinska University Hospital, Danderyd Hospital, University Hospital, Linkoeping, Sunderby Hospital, Aarhus University Hospital, Örebro University, Sweden, Odense University Hospital, Skane University Hospital, Rigshospitalet, Denmark
Conditions	Pulmonary Embolism
Enrollment	220 participants
Start Date	2025-04-01
Primary Completion	2028-05-01 (estimated)
Study Completion	2029-05-01 (estimated)
Updated on ClinicalTrials.gov	2026-01-21