Role of catheter-based interventions in treating pulmonary embolism

Pulmonary embolism (PE) ranks as the third leading cause of cardiovascular-related deaths in Western nations. Patients classified as high-risk (HR)-those exhibiting hemodynamic instability-require immediate interventions to restore blood flow. While intermediate-HR (IHR) individuals remain hemodynamically stable, they face a significant chance of clinical decline and thus need close and continuous observation. Effective risk assessment, mortality prediction, and therapeutic decision-making in these patients rely on a combination of clinical evaluation and imaging studies. Catheter-directed therapy (CDT) has emerged as a promising option, offering the ability to alleviate clot burden and reduce strain on the right ventricle, all while posing a lower risk of major bleeding compared to systemic thrombolysis. The growing adoption of CDT reflects its increasing relevance in PE treatment, especially when managed by specialized PE response teams that ensure individualized, multidisciplinary care. As clinical practices evolve, further studies and robust clinical trials are necessary to clearly define CDT's role in lowering the risks of complications and death among IHR PE patients. This article explores the current understanding and future direction of managing PE, focusing in the role of catheter-based interventions.