Catheter-directed therapy for acute pulmonary embolism: results of a multicenter national registry

Introduction and objectives: Catheter -directed therapy (CDT) for acute pulmonary embolism (PE) is an emerging therapy that combines heterogeneous techniques. The aim of the study was to provide a nationwide contemporary snapshot of clinical practice and CDT -related outcomes. Methods: This Investigator -initiated multicenter registry aimed to include consecutive patients with intermediate -high risk (IHR) or high -risk (HR), acute PE eligible for CDT. The primary outcome of the study was in -hospital all -cause death. Results: A total of 253 patients were included, of whom 93 (36.8%) had HR -PE, and 160 (63.2%) had IHRPE with a mean age of 62.3 +/- 15.1 years. Local thrombolysis was performed in 70.8% and aspiration thrombectomy in 51.8%, with 23.3% of patients receiving both. However, aspiration thrombectomy was favored in the HR -PE cohort (80.6% vs 35%; P < .001). Only 51 patients (20.2%) underwent CDT with specific PE devices. The success rate for CDT was 90.9% (98.1% of IHR-PE patients vs 78.5% of HR -PE patients, P < .001). In -hospital mortality was 15.5%, and was highly concentrated in the HR -PE patients (37.6%) and significantly lower in IHR-PE patients (2.5%), P < .001. Long-term (24 -month) mortality was 40.2% in HR -PE patients vs 8.2% in IHR-PE patients (P < .001). Conclusions: Despite the high success rate for CDT, in -hospital mortality in HR -PE is still high (37.6%) compared with very low IHR-PE mortality (2.5%). (c) 2023 Sociedad Espa & ntilde;ola de Cardiolog & iacute;a. Published by Elsevier Espa & ntilde;a, S.L.U. All rights reserved.