Original Research

DOI: 10.4244/EIJ-D-24-00555

Early versus delayed catheter-based therapies in patients hospitalised with acute pulmonary embolism

Orly Leiva1, MD; Rachel P. Rosovsky2, MD, MPH; Carlos Alviar1, MD; Sripal Bangalore1, MD, MHA

Abstract

Background: Acute pulmonary embolism (PE) is a common cause of cardiovascular morbidity and mortality. Catheter-based therapies (CBT) are emerging technologies that provide reperfusion for patients with PE. However, the optimal timing of these interventions from initial presentation is unknown.

Aims: This study aimed to determine whether the timing of CBT affects outcomes among patients with acute PE managed with CBT.

Methods: This was a retrospective cohort study of patients with PE who underwent CBT and were included in the Nationwide Readmissions Database between January 2017 and December 2020. Patients who underwent early CBT (≤1 day from admission) were compared with those who underwent delayed CBT (>1 day). The primary outcome was death at 90 days, and secondary outcomes included 90-day readmissions. Propensity scores were estimated using logistic regression, and propensity score weighting (PSW) was utilised to compare outcomes between early and delayed CBT. Cox proportional hazards modelling was used to estimate the risk of primary and readmission outcomes.

Results: A total of 12,137 patients were included: 1,992 (16.4%) had high-risk PE, and 1,856 (15.3%) were treated with delayed CBT. After PSW, early CBT was associated with a lower risk of 90-day death in both intermediate-risk (hazard ratio [HR] 0.55, 95% confidence interval [CI]: 0.46-0.66) and high-risk (HR 0.89, 95% CI: 0.80-0.99) PE. Early CBT was associated with lower rates of all-cause readmission in patients with intermediate-risk PE (HR 0.86, 95% CI: 0.78-0.95) and in those with high-risk PE (HR 0.84, 95% CI: 0.69-1.05).

Conclusions: Among patients with intermediate- or high-risk PE, early CBT was associated with a lower risk of 90-day death and readmission. A further prospective study on the optimal timing for reperfusion using CBT is needed.

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 21 Number 9
May 5, 2025
Volume 21 Number 9
View full issue


Key metrics

Suggested by Cory

Editorial

10.4244/EIJ-E-22-00058 Feb 20, 2023
Mechanical thrombectomy for pulmonary embolism revisited: technological breakthrough or simple renovation?
Rheude T and Kufner S
free

EXPERT REVIEW

10.4244/EIJ-D-17-00437 Feb 20, 2018
Catheter-based therapies in acute pulmonary embolism
Schultz J et al
free

Clinical research

10.4244/EIJ-D-23-00399 Nov 17, 2023
A nationwide analysis of reperfusion therapies for pulmonary embolism in older patients with frailty
Farmakis IT et al
free

Editorial

10.4244/EIJ-E-23-00047 Nov 17, 2023
Catheter directed therapies: an option for elderly frail patients with pulmonary embolism requiring reperfusion
Pruszczyk P and Kopeć G
free

Clinical research

10.4244/EIJ-D-22-00732 Feb 20, 2023
Acute outcomes for the full US cohort of the FLASH mechanical thrombectomy registry in pulmonary embolism
Toma C et al
free

State-of-the-Art

10.4244/EIJ-D-23-00895 Apr 1, 2024
Percutaneous interventions for pulmonary embolism
Finocchiaro S et al
free

Viewpoint

10.4244/EIJ-D-24-00267 Sep 16, 2024
Is it time for a myocardial infarction approach to high- and intermediate-high-risk pulmonary embolism?
Zuin M and Piazza G
free
Trending articles
69.996

10.4244/EIJV13I12A217 Dec 8, 2017
Swimming against the tide: insights from the ORBITA trial
Al-Lamee R and Francis D
free
60.9

State-of-the-Art

10.4244/EIJ-D-24-00066 Apr 21, 2025
Management of complications after valvular interventions
Bansal A et al
free
57.6

State-of-the-Art

10.4244/EIJ-D-24-00386 Feb 3, 2025
Mechanical circulatory support for complex, high-risk percutaneous coronary intervention
Ferro E et al
free
38.75

State-of-the-Art

10.4244/EIJ-D-23-00912 Oct 7, 2024
Optical coherence tomography to guide percutaneous coronary intervention
Almajid F et al
free
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2025 Europa Group - All rights reserved