About the Study

Background

International guidelines recommend immediate reperfusion with systemic thrombolysis (ST) as first-line treatment in high-risk pulmonary embolism (PE). The therapy improves haemodynamics and overall survival but is also associated with a significant risk of severe bleeding.

Catheter-directed intervention (CDI) is recommended as an alternative reperfusion therapy in high-risk PE when ST is contraindicated or has failed, as well as in patients who deteriorate or fail to improve during anticoagulation (AC) treatment.

Despite lack of high-quality evidence and randomized studies between CDI and standard care, the use of CDI is spreading rapidly in high-risk PE and in less severe PE not fulfilling current treatment criteria.

Several CDI methods are available, including mechanical thrombectomy (MT) and catheter-directed thrombolysis (CDT), but no method is currently recommended over the other. In Sweden, the MT device FlowTriever® (FT) was introduced in 2021 and has since then been the predominant method.

Treatment of acute PE using CDI is an evolving strategy as to techniques and availability. Follow-up of outcomes and safety is important when new techniques are employed. The PE-NORDIC observational study will evaluate short- and long-term safety and effect outcomes in patients with PE treated with CDI and ST in Sweden and other Nordic countries.