Tuesday Session 5: Advances in Pulmonary Embolism Care

Outcomes and Disparities

New data showed catheter-directed intervention for submassive PE improved conditional
two-year survival to 91% versus 79% with anticoagulation alone. A national database
analysis found thrombectomy reduced in-hospital mortality overall, but Hispanic and Asian
patients received it far less often than white patients and had higher mortality,
pointing to access rather than biology as a likely driver.

Technology and Technique

Newer aspiration thrombectomy devices with combined pressure and flow sensing were
associated with lower mortality and fewer life-threatening bleeds than earlier systems.
Faculty reviewed steps for right heart crossing, catheter selection to avoid chordal
injury, and completion angiography confirming lung perfusion.

Risk Stratification and Guidelines

New AHA classifications divide risk into five categories, A through E, with more
permissive language around catheter-based intervention for intermediate-high risk
patients, though recommendations for high clot burden or residual DVT remain limited.

Building a PERT Program

Speakers outlined the case for pulmonary embolism response teams, linked to faster
anticoagulation and fewer bleeding complications, and offered steps for assembling
stakeholders and tracking outcomes through a registry.