Closing the Gap: Mechanical Thrombectomy for Acute Pulmonary Embolism in Regional and Rural North Queensland,...

To evaluate the feasibility and early outcomes of large-bore mechanical thrombectomy for intermediate-high- and high-risk pulmonary embolism (PE) in a regional Australian tertiary referral center.

A retrospective cohort study was conducted at a regional tertiary hospital in North Queensland between January 2022 and June 2025. Consecutive patients undergoing mechanical thrombectomy following multidisciplinary Pulmonary Embolism Response Team evaluation were included. Demographic, procedural, and short-term clinical outcomes were analyzed descriptively.

Twenty-three patients underwent mechanical thrombectomy. Technical success was achieved in all cases (100%), with no immediate procedural complications. Eleven patients (47.8%) required postprocedural intensive care unit admission. Mean oxygenation saturation increased modestly following intervention (94.7% to 96.4%), although interpretation is limited by heterogeneity in oxygen support. Among 17 patients with follow-up imaging within 48 hours, 6 (35.3%) demonstrated reduction in right ventricular to left ventricular ratio to < 0.9. The mean hospital length of stay was 17.9 ± 21.6 days (median 9 days). Thirty-day mortality was 8.7%.

Large-bore mechanical thrombectomy for acute PE was feasible and safely delivered in a regional Australian center, with acceptable short-term outcomes in a high-risk cohort. These findings support the potential for appropriately resourced regional centers to provide advanced interventional PE care.