Cath-Directed Fibrinolysis to Treat PE

Clinicians have a variety of conservative and catheter-directed options for managing intermediate-high–risk pulmonary embolism (PE). However, we don’t yet know whether catheter-directed fibrinolysis is more effective than anticoagulant monotherapy at preventing clinical deterioration — and whether it increases bleeding risk. To address this gap, researchers randomized 558 patients with intermediate-high–risk PE (defined by a simplified PE Severity Index score ≥1, right ventricular dysfunction, and elevated cardiac biomarkers) to anticoagulation alone or anticoagulation with catheter-directed fibrinolysis.