PERT Implementation and the Changing Profile of Patients Undergoing Catheter-Based Pulmonary Embolism Treatment: a...

Despite growing evidence supporting pulmonary embolism response teams (PERT) in high-income countries, published experience from Latin America remains scarce. We assessed the association between PERT implementation and 30-day clinical outcomes in patients with acute PE treated with catheter-based therapy (CBT) in a Latin American university hospital.

Retrospective cohort study including consecutive patients with confirmed acute PE treated with CBT between 2004 and 2025. Patients were stratified by treatment era (pre-PERT: 2004-2020; PERT: 2021-2025). The primary endpoint was 30-day major adverse cardiovascular events (MACE), defined as a composite of all-cause death, stroke, or major bleeding (BARC grade ≥3).

A total of 53 patients were included: 26 (49%) pre-PERT and 27 (51%) PERT era. ESC high-risk patients predominated in the pre-PERT era (17 (65%) vs 6 (22%); p=0.002), while intermediate-high risk predominated in the PERT era (9 (35%) vs 21 (78%); p=0.002). Dedicated thrombectomy devices were used universally in the PERT era (14 (54%) vs 27 (100%); p<0.001). MACE occurred in 10 (38%) vs 4 (15%) patients (p=0.06). In a subanalysis restricted to intermediate-high risk patients, 30-day mortality was 0/21 (0%) in the PERT era versus 3/9 (33%) in the pre-PERT era (p=0.021).

In one of the few Latin American reports on PERT-guided CBT, implementation was associated with a shift toward intermediate-high risk patients, greater use of mechanical thrombectomy, and lower thrombolytic exposure, without an increase in major bleeding. Among intermediate-high risk patients, 30-day mortality was significantly lower in the PERT era, supporting the safety and potential benefit of structured multidisciplinary PE management in resource-limited settings.