TCT Conference 24 - PEERLESS II shows benefit of large-bore mechanical thrombectomy compared to catheter-directed thrombolysis for intermediate-risk pulmonary embolism (PE) patients.

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

PEERLESS is a prospective, multicenter, randomized controlled trial, where patients with intermediate-risk acute PE were randomised 1:1 to receive either the FlowTriever System (Inari Medical) plus AC, or AC alone. 1200 patients were enrolled in the trial and were followed up through discharge and at 48-hour, 1, 2 and 3 months after randomisation. The primary outcome measures were the hierarchical occurrence of clinical deterioration defined by hemodynamic or respiratory worsening, all-cause hospital re-admission by 30 days, bailout therapy or dyspnea.

PEERLESS met its primary endpoint, demonstrating the superiority of large-bore mechanical thrombectomy when compared to catheter-directed thrombolysis in treating patients with acute to intermediate risk pulmonary embolism. There was no observed difference in mortality, intracerebral haemorrhage and major bleeding. LBMT was associated with less clinical deterioration or escalation of therapy, faster clinical and hemodynamic improvement at 24 hours, less ICU use and fewer readmissions through 30 days.

Interview Questions:

1. What is the reasoning behind this trial?
2. Could you tell us about the patient population and study design for PEERLESS?
3. What are the key findings?
4. How should these findings impact clinical practice?
5. What further study is needed in this area?

Recorded on-site at TCT Conference in Washington, 24

Editors: Yazmin Sadik, Jordan Rance
Videographers: David Ben-Harosh, Oliver Miles

Support: This is an independent interview produced by Radcliffe Cardiology.