
Pulmonary Embolism
Pulmonary Embolism Resource Hub
Venous thromboembolism is a serious disease. Both deep vein thrombosis and pulmonary embolism frequently result in devastating impacts for patients in both the short and the long term. Pulmonary Embolism affects about 1000 out of every 1 million people with 200 of those cases considered to have an intermediate-high and high risk of mortality. Pulmonary Embolism, while preventable, is the 3rd leading cause of cardiovascular death.
As high mortality rates have shown little improvement over the last 20 years, it is clear acute PE patients need to be managed differently. We know that conservative treatment options, as recommended by the guidelines, leave thrombus behind in 20-50% of patients. Literature shows the mortality number on anticoagulation only is still high and the majority of venous clot is lytic-resistant by the time of treatment. Thrombolysis comes with significant risk of bleeds.
This section presents key papers, IHR and HR PE case reports, and also interviews with Key Opinion Leaders discussing how new technologies, like a lytic-free thrombectomy, can transform the treatment of acute Pulmonary Embolism.
Endorsed by Prof Felix Mahfoud
Pulmonary embolism remains a leading cause of cardiovascular death, with high mortality and morbidity rates showing little improvement over the last 20 years. This section explores how innovative treatment options, such as mechanical thrombectomy, along with new approaches to risk stratification and patient selection, can improve acute PE management and patient outcomes.
As high mortality rates have shown little improvement over the last 20 years, it is clear acute PE patients need to be managed differently. We know that conservative treatment options, as recommended by the guidelines, leave thrombus behind in 20-50% of patients. Literature shows the mortality number on anticoagulation only is still high and the majority of venous clot is lytic-resistant by the time of treatment. Thrombolysis comes with significant risk of bleeds.
This section presents key papers, IHR and HR PE case reports, and also interviews with Key Opinion Leaders discussing how new technologies, like a lytic-free thrombectomy, can transform the treatment of acute Pulmonary Embolism.
Endorsed by Prof Felix Mahfoud
Pulmonary embolism remains a leading cause of cardiovascular death, with high mortality and morbidity rates showing little improvement over the last 20 years. This section explores how innovative treatment options, such as mechanical thrombectomy, along with new approaches to risk stratification and patient selection, can improve acute PE management and patient outcomes.
The Pulmonary Embolism Hub is supported by

Highlights
Dr Stefan Stortecky (Bern University Hospital, Bern, CH) joins us to discuss outcomes from a parallel, non-randomised registry from the PEERLESS (NCT05111613) cohort. The contraindication cohort investigated large-bore mechanical thrombectomy with the FlowTriever system for intermediate-risk PE in patients with contraindications to thrombolytic therapy.
In this session, Prof Ingo Ahrens discusses the unmet needs in PE care and current risk stratifications, focusing on the gaps for intermediate-high risk patients and the need for structured assessment and rigorous scientific assessment of new reperfusion therapies.
This session explores the current challenges faced in the ICU, and how new therapies could overcome these. Prof Thomas Cuisset discusses the current guidelines and consensus statements, and utilises a patient case study to illustrate and discuss the need for teamwork, robust clinical evidence and optimised risk stratification in PE care.
The key points of this session by Dr Stefan Stortecky include the history and timeline of randomised evidence in the PE clinical trial landscape, examining the rational and need for these studies, before discussing primary outcomes from PEERLESS, the first randomised clinical trial evaluating mechanical thrombectomy vs catheter directed thrombolysis.
Clinical Updates

Prof Felix Mahfoud gives a brief welcome, outlining the programme agenda and prompting the live audience to share their current access to mechanical thrombectomy and catheter directed devices for PE management.

In this session, Prof Ingo Ahrens discusses the unmet needs in PE care and current risk stratifications, focusing on the gaps for intermediate-high risk patients and the need for structured assessment and rigorous scientific assessment of new reperfusion therapies.

This session explores the current challenges faced in the ICU, and how new therapies could overcome these. Prof Thomas Cuisset discusses the current guidelines and consensus statements, and utilises a patient case study to illustrate and discuss the need for teamwork, robust clinical evidence and optimised risk stratification in PE care.

The faculty discuss risk stratification and decision making in PE management.

The key points of this session by Dr Stefan Stortecky include the history and timeline of randomised evidence in the PE clinical trial landscape, examining the rational and need for these studies, before discussing primary outcomes from PEERLESS, the first randomised clinical trial evaluating mechanical thrombectomy vs catheter directed thrombolysis.

In this session, Dr Jay Giri offers insights into the future landscape of care for PE patients.

The faculty engage in an interactive discussion on navigating the clinical evidence.

Prof Felix Mahfoud concludes the webinar with key reflections and a final audience poll to assess potential changes in their PE management practices.

Dr Jay Giri (University of Pennsylvania, Philadelphia, US), highlights the PEERLESS trial's importance in advancing PE management, being the first major RCT in a decade to evaluate thrombectomy.

Prof Stefan Stortecky (Bern University Hospital, Bern, CH) introduces the win ratio approach, a method that ranks outcomes hierarchically based on clinical significance, offering a clearer insight into study results.

Dr Wissam A Jaber (Emory University Hospital Midtown, US) joins us onsite at TCT Conference to discuss the findings from PEERLESS (NCT06055920; Inari Medical).

Dr Stefan Stortecky (Bern University Hospital, Bern, CH) joins us to discuss outcomes from a parallel, non-randomized registry from the PEERLESS (NCT05111613) cohort. The contraindication cohort investigated large-bore mechanical thrombectomy with the FlowTriever system for intermediate-risk PE in patients with contraindications to thrombolytic therapy.

Join Prof Felix Mahfoud, University Hospital Basel (CH), as he shares his approach to risk stratification for Intermediate-High PE patients. Discover the significance of prevention from normotensive shock and learn how to better assess and identify patients on the edge of deterioration, potentially benefiting from interventional treatment.

In this video, learn from Dr Tom Tu (Inari Medical, US), Prof Felix Mahfoud (University Hospital Basel, CH) and Dr Jay S Giri (Hospital of the University of Pennsylvania, US) about using practical case examples, how mechanical thrombectomy can improve the mortality risk of High-risk PE patients and why the FLAME study disrupts the current level of clinical evidence in High-risk PE patients.

Dr Mitchell Silver shares his experiences in the treatment of high-risk PE patients and explains why mortality of those patients haven’t significantly improved over the last 20 years. Watch this interview to learn more about the FLAME’s outcomes – the largest prospective study of interventional treatment in High-risk PE.
Acute PE Risk Stratification

The aim of this approach is to reduce the mortality rate of Intermediate PE patients, which can still reach up to 15%. Prof Sripal Bangalore, New York University School of Medicine (US), explains why anticoagulation therapy does not suffice in certain cases and advocates for intervention in stable normotensive acute PE patients.

Prof Catalin Toma, University of Pittsburgh School of Medicine, Pittsburgh, US, shares his expertise in managing Intermediate-High and High-Risk PE, emphasising the pivotal role of an interventional treatment in patient care. “It’s not what PA can do for you but what aspiration thrombectomy can do for your patient”.

Up to 40% of “intermediate-risk” PE patients have a low cardiac index, which is suggestive for subclinical shock. It is impossible to predict which patients may decompensate. Even though proven predictors for PE mortality exist, they are not being considered by current guidelines. What can help to transform an approach for acute PE treatment?

Does the current standard of care for PE patients keep up with the latest clinical evidence? Hear from Dr Stefano Barco (University Hospital Zurich, Zurich,CH), Prof Catalin Toma (University of Pittsburgh School of Medicine, Pittsburgh, US,) and Prof Bernhard Gebauer (Charité – Berlin University Medicine, Berlin, DE) to learn more about the gaps and limitations in current treatment guidelines and how the latest clinical updates can help to define the patient group eligible for the interventional treatment of acute PE.
When to Intervene?

In this video, Dr William Ricketts (Barts Health NHS Trust, London, UK) and Dr Rashid Akhtar (The Royal London Hospital, London, UK) discuss the importance of a multidisciplinary approach in treating patients with PE. They highlight its benefits and share their first-hand experiences, emphasising how collaboration among specialists leads to better patient outcomes.

In this interview, Dr William Ricketts (Barts Health NHS Trust, London, UK) and Dr Rashid Akhtar (The Royal London Hospital, London, UK) discuss how to activate a Pulmonary Embolism Response Team (PERT) and share the most rewarding aspects of a multidisciplinary approach in managing PE.

Dr William Ricketts (Barts Health NHS Trust, London, UK) and Dr Rashid Akhtar (The Royal London Hospital, London, UK) discuss how they assess PE patients for interventional treatment and the criteria for cases reviewed by their PERT team. They share insights on patient selection and the decision-making process in acute PE management.

What does mechanical thrombectomy bring to the PE patient pathway? Hear from Dr Ole Gretta (Oslo University Hospital, NO), Dr Ana Viana-Tejedor (Hospital Clínico San Carlos, Madrid, ES) and Dr Maximilian de Bucourt (Charité Campus Benjamin Franklin, Berlin, DE) to learn from practical European examples, how a PE referral network and a standardised PE pathway can impact the treatment and outcomes of acute PE patients.

Ensuring that all acute PE patients admitted to the hospital are properly assessed and receive the most effective treatment is crucial. Dr Ana Viana-Tejedor and Dr Pablo Salinas from Hospital Clínico San Carlos in Madrid, share their insights and experiences on how to achieve this.

How can we ensure that every PE patient admitted to hospital follows a consistent pathway and receives treatment based on standardised criteria? Join Dr Ana Viana-Tejedor and Dr Pablo Salinas from Hospital Clínico San Carlos in Madrid as they discuss the key parameters they consider when selecting the right treatment for their PE patients.

This document provides a detailed overview of the treatment decision tree for pulmonary embolism (PE) based on the latest guidelines and consensus statements.
This downloadable PDF serves as a practical tool for HCPs to navigate the complexities of PE treatment, ensuring evidence-based care that aligns with the latest standards.

This downloadable PDF outlines the treatment pathway for patients diagnosed with acute pulmonary embolism (PE) developed at Hospital Clínico San Carlos in Madrid. The pathway is designed to guide clinicians from this centre through the critical steps of managing high-risk and intermediate-high-risk PE cases.
Mechanical Thrombectomy in Action

European experience in achieving an immediate impact using a lytic-free approach to acute PE treatment. Learn from experience European centers how mechanical thrombectomy can improve the outcomes of intermediate-high and high risk PE patients, using a lytic-free approach with immediate hemodynamic impact.

Young woman developed a High-Risk PE post hip surgery and was placed on ECMO. Mechanical thrombectomy using 24 French in combination with a 16 French Triever catheter cleared the Pulmonary arteries and stabilised the patient on the table.

Patient with known history of PE and DVT experienced a syncope and was diagnosed with a massive PA thrombus load, elevated right heart strain and troponin. Combination of aspiration and mechanical thrombectomy with FlowTriever disks removed both acute and sub-acute thrombus and resulted in an immediate haemodynamic improvement on the table.

Young female with an intermediate-high risk, normotensive, saddle PE did not respond to conservative treatment on anticoagulation. 8 aspirations with the FlowTriever system removed the large saddle embolus and resulted in an immediate reduction of the Pulmonary Artery Pressure on the table.

In this video, a patient admitted at the ER department with dyspnea and diagnosed with an intermediate-high risk Pulmonary embolism with elevated RV strain and troponin level. Great thrombus clearance using different tools of the FlowTriever system, resulting in an immediate haemodynamic impact.
Patient Stories

Andrea's acute pulmonary embolism treated by Dr Moazz Elsharabassy (GE).

Vanessa's pulmonary embolism treated by Dr Mohammed Rashid Akhtar (UK).

Gema's pulmonary embolism at 28 weeks, treated by Dr Alfonso Jurado Roman (Madrid, ES).
Clinical Publications

Bangalore S, Horowitz JM, Beam D, et al. JACC Cardiovasc Interv 2023;16:958–72.

Toma C, Jaber WA, Weinberg MD, et al. EuroIntervention 2023;18:1201–12.

Toma C, Bunte MC, Cho KH, et al. Catheter Cardiovasc Inter 2022;99:1345–55.

Silver MJ, Gibson CM, Giri J et al. Circ Cardiovasc Interv 2023;16:e013406.

Toma C, Khandhar S, Zalewski AM et al. Catheter Cardiovasc Interv 2020;96:1465–70.

Zhang RS, Alman U, Sharp ASP et al. Circ Cardiovasc Interv 2024;17:e013399.

Welker C, Huang J, Elmadhoun O et al. J Cardiothorac Vasc Anesth 2024;38:1239–43.

Sagoschen I, Scibior B, Farmakis IT et al. Clin Res Cardiol 2024;113:581–90.

Hani Al-Terki, Lauder L, Mügge A et al. Catheter Cardiovasc Interv 2024;103:758–65.

Zhang RS, Alviar CL, Yuriditsky E et al. Catheter Cardiovasc Interv 2024;103:1042–49.

Zhang RS, Yuriditsky E, Zhang P et al. Circ Cardiovasc Interv 2024;e014088.