Objective
to determine whether ultrasound-facilitated, catheter-directed fibrinolysis in addition to anticoagulation leads to lower risks of adverse events compared to anticoagulation alone
Study
multinational, adaptive-design trial with blinded outcome adjudication
Population
patients with intermediate-risk pulmonary embolism (with a ratio of right ventricular end-diastolic diameter to left ventricular end-diastolic diameter of 1.0 and an elevated troponin level)
Endpoints
composite of pulmonary embolism-related death, cardiorespiratory decompensation or collapse, or symptomatic recurrence of pulmonary embolism within 7 days
Conclusion
Among patients with acute, intermediate-risk pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis plus anticoagulation resulted in a lower risk of the primary composite outcome within 7 days compared to anticoagulation alone.
Rosenfield et al. N Engl J Med. 2026 Mar 28.