Improved Outcomes for Pulmonary Embolism Patients with Novel Therapies

Strategic Insights -

Research conducted by Hadassah Medical Center in Jerusalem, Israel, has shed light on alternative treatments for patients with hemodynamically significant pulmonary embolism (PE). The study, published in Thrombosis Research, compared the outcomes of patients treated with catheter-directed interventions (CDI), surgical embolectomy (SE), and systemic thrombolysis (ST). The results indicate that CDI and SE are associated with improved survival rates, reduced major bleeding, and better right ventricular function compared to ST.

Key Takeaways:

  • The study involved 1598 patients with intermediate- or high-risk PE, with 683 treated with CDI, 224 with SE, and 691 with ST.
  • A network meta-analysis revealed a significant decrease in early mortality in patients treated with CDI or SE compared to ST (odds-ratio (OR) 0.34, 95% confidence interval (CI) 0.17-0.68, and OR = 0.37, 95% CI (0.16-9.85), respectively).
  • CDI had the highest P-score (0.87), followed by SE (0.63), and ST (0.0008) in the ranking of therapeutic modalities.
  • CDI resulted in less RV dysfunction (OR = 0.28, 95% CI (0.1-0.76) and a trend for less bleeding complications compared to ST.
  • The study suggests that CDI and SE are associated with superior survival compared to ST in patients with moderate- and high-risk PE.

Statistics:

  • 4283 studies were identified, with 15 studies included in the final analysis.
  • 1598 patients were involved in the study, with 683 treated with CDI, 224 with SE, and 691 with ST.
  • The study encompassed 3595.5 patient years.
  • The odds-ratio (OR) for early mortality in CDI and SE groups compared to ST was 0.34 (95% CI 0.17-0.68) and 0.37 (95% CI (0.16-9.85)), respectively.
  • The P-score for CDI was 0.87, followed by SE (0.63) and ST (0.0008) in the ranking of therapeutic modalities.
  • The study found a trend for less bleeding complications with CDI compared to ST.

Sources:

  • Has systemic thrombolysis run its course? A systematic review and network meta-analysis of patients with intermediate- and high-risk pulmonary embolism. Thrombosis Research, 2025;255:109503.
  • Thrombosis Research, Pergamon-elsevier Science Ltd, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England. (Elsevier - www.elsevier.com; Thrombosis Research - www.journals.elsevier.com/thrombosis-research/)