Catheter directed therapies: an option for elderly frail patients with pulmonary embolism requiring reperfusion

Current guidelines of the European Society of Cardiology indicate that the optimal management of acute pulmonary embolism (PE) depends on the risk assessment of PE-related early mortality1. Reperfusion therapy, preferably systemic thrombolysis, is still recommended as the first-line treatment in haemodynamically unstable patients. It should also be considered as a rescue therapy when initially normotensive subjects deteriorate despite adequate anticoagulation1. However, real life shows that more than half of high-risk PE patients do not receive systemic thrombolysis because of increased risk of bleeding2. Since the rate of major extracranial bleeding reached 11.1% in patients above 75 years of age in the PEITHO ...