Link to fresh blog below
The trial surely has limitations, but it's been increasingly clear that catheter-directed thrombolysis is silly for over a decade now
TBH, this is a wild story about device manufacturers using sponsored RCTs to torture EBM
emcrit.org/pulmcrit/cdt/
The trial surely has limitations, but it's been increasingly clear that catheter-directed thrombolysis is silly for over a decade now
TBH, this is a wild story about device manufacturers using sponsored RCTs to torture EBM
emcrit.org/pulmcrit/cdt/
PulmCrit: Catheter-directed lysis = Peripheral lysis for PE (STRATIFY trial!)
Catheter-directed thrombolysis for PE has always been a silly idea, for numerous reasons: Clots are widely distributed throughout both lungs. 100% of the
emcrit.org
March 6, 2026 at 3:06 PM
Link to fresh blog below
The trial surely has limitations, but it's been increasingly clear that catheter-directed thrombolysis is silly for over a decade now
TBH, this is a wild story about device manufacturers using sponsored RCTs to torture EBM
emcrit.org/pulmcrit/cdt/
The trial surely has limitations, but it's been increasingly clear that catheter-directed thrombolysis is silly for over a decade now
TBH, this is a wild story about device manufacturers using sponsored RCTs to torture EBM
emcrit.org/pulmcrit/cdt/
Fresh blog: STRATIFY trial for PE
Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis
Catheter-directed thrombolysis for PE is dead
We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)... #1/2 #EMIMCC
Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis
Catheter-directed thrombolysis for PE is dead
We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)... #1/2 #EMIMCC
March 6, 2026 at 3:06 PM
Fresh blog: STRATIFY trial for PE
Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis
Catheter-directed thrombolysis for PE is dead
We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)... #1/2 #EMIMCC
Peripheral tPA infusion is EQUALLY EFFECTIVE as compared to ultrasound-assisted thrombolysis
Catheter-directed thrombolysis for PE is dead
We can get the same benefits with peripheral tPA infusions (w/o procedural costs & complications)... #1/2 #EMIMCC
the only band I’ve seen open for Embolus was Catheter Directed Therapy
March 16, 2024 at 6:17 PM
the only band I’ve seen open for Embolus was Catheter Directed Therapy
Finally, a randomised trial on thrombectomy in intermediate risk pulmonary embolism (though not not compared with our standard of care). Less RV dysfunction, shorter stay. #cardiosky #critcaresky #emsky
Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial | Circul...
Background: There is a lack of randomized controlled trial (RCT) data comparing outcomes
of different catheter-based interventions for intermediate-risk pulmonary embolism
(PE). Methods: PEERLESS is a...
www.ahajournals.org
November 9, 2024 at 8:22 PM
Finally, a randomised trial on thrombectomy in intermediate risk pulmonary embolism (though not not compared with our standard of care). Less RV dysfunction, shorter stay. #cardiosky #critcaresky #emsky
From @nejm.org 🫁
Catheter-directed #thrombolysis plus #anticoagulation was associated with reduced risk of mortality among patients with acute #PulmonaryEmbolism.
#PulmSky #CriticalCare
Catheter-directed #thrombolysis plus #anticoagulation was associated with reduced risk of mortality among patients with acute #PulmonaryEmbolism.
#PulmSky #CriticalCare
Catheter-Directed Thrombolysis Plus Anticoagulation Supported in Acute PE
Among patients with acute PE, those who undergo catheter-directed thrombolysis plus anticoagulation therapy show better outcomes.
www.pulmonologyadvisor.com
October 2, 2026 at 11:45 PM
From @nejm.org 🫁
Catheter-directed #thrombolysis plus #anticoagulation was associated with reduced risk of mortality among patients with acute #PulmonaryEmbolism.
#PulmSky #CriticalCare
Catheter-directed #thrombolysis plus #anticoagulation was associated with reduced risk of mortality among patients with acute #PulmonaryEmbolism.
#PulmSky #CriticalCare
🫀 Clot buster cuts lung clot deaths
A Czech trial of 558 people with dangerous lung clots found feeding clot dissolving drugs straight into the lung artery cut deaths and repeat clots to under 1%, against nearly 7% on blood thinners alone.
🔗 doi.org/10.1056/nejmoa2608012
#Health #Medicine 🧪
A Czech trial of 558 people with dangerous lung clots found feeding clot dissolving drugs straight into the lung artery cut deaths and repeat clots to under 1%, against nearly 7% on blood thinners alone.
🔗 doi.org/10.1056/nejmoa2608012
#Health #Medicine 🧪
Catheter-Directed Thrombolysis in Intermediate-High–Risk Pulmonary Embolism | NEJM
Whether catheter-directed thrombolysis improves clinical outcomes in patients with intermediate-high–risk pulmonary embolism, as compared with anticoagulation alone, is uncertain. In this multicent...
doi.org
September 4, 2026 at 5:11 AM
🫀 Clot buster cuts lung clot deaths
A Czech trial of 558 people with dangerous lung clots found feeding clot dissolving drugs straight into the lung artery cut deaths and repeat clots to under 1%, against nearly 7% on blood thinners alone.
🔗 doi.org/10.1056/nejmoa2608012
#Health #Medicine 🧪
A Czech trial of 558 people with dangerous lung clots found feeding clot dissolving drugs straight into the lung artery cut deaths and repeat clots to under 1%, against nearly 7% on blood thinners alone.
🔗 doi.org/10.1056/nejmoa2608012
#Health #Medicine 🧪
In patients with pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis led to a lower risk of a composite of major adverse outcomes than anticoagulation alone. Full HI-PEITHO trial results and Research Summary: https://nej.md/4uMu4lv
June 1, 2026 at 4:00 PM
In patients with pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis led to a lower risk of a composite of major adverse outcomes than anticoagulation alone. Full HI-PEITHO trial results and Research Summary: https://nej.md/4uMu4lv
Science! Have you read the #PEERLESS trial comparing #thrombectomy (#LBMT) with #catheter-directed #thrombolysis (#CTD) for Intermediate-risk #pulmonary #embolism (#PE)? A critical read and analysis: 🧵1/5 doi.org/10.1161/CIRC...
Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial | Circul...
Background: There is a lack of randomized controlled trial (RCT) data comparing outcomes
of different catheter-based interventions for intermediate-risk pulmonary embolism
(PE). Methods: PEERLESS is a...
doi.org
November 19, 2024 at 9:22 AM
Science! Have you read the #PEERLESS trial comparing #thrombectomy (#LBMT) with #catheter-directed #thrombolysis (#CTD) for Intermediate-risk #pulmonary #embolism (#PE)? A critical read and analysis: 🧵1/5 doi.org/10.1161/CIRC...
Due to logistical reasons, patient was able to go to Interventional radiology the next day. Thrombectomy was attempted (PAP: 65/35/45) but was unsuccessful. Catheter-directed thrombolysis was initiated & lasted 20 hours before switcH to heparin drip & eventually apixaban
February 1, 2025 at 10:20 PM
Due to logistical reasons, patient was able to go to Interventional radiology the next day. Thrombectomy was attempted (PAP: 65/35/45) but was unsuccessful. Catheter-directed thrombolysis was initiated & lasted 20 hours before switcH to heparin drip & eventually apixaban
Just got woken up to approve a transfer for a renal infarction. Why the fuck did they need my permission for that? Also, what am *I* going to do about a renal infarction? I’m not the one who will do catheter-directed thrombolysis!
September 29, 2024 at 7:32 AM
Just got woken up to approve a transfer for a renal infarction. Why the fuck did they need my permission for that? Also, what am *I* going to do about a renal infarction? I’m not the one who will do catheter-directed thrombolysis!
Patient required 2-3 l/m O2 via nasal cannula. Hemodynamics remained stable. A day later, he suffered massive intracranial hemorrhage and died...
Not every catheter-directed thrombolysis or suction thrombectomy is a success story!
#foamed #foamcc #meded #Medsky #emimcc #pulmsky
Not every catheter-directed thrombolysis or suction thrombectomy is a success story!
#foamed #foamcc #meded #Medsky #emimcc #pulmsky
October 10, 2025 at 8:11 PM
Il fut un temps lointain où publier dans Circulation était le Graal en cardiologie.
Maintenant, vous pouvez passer des papiers ou des gens font mumuse avec des joujous, sans s’embarrasser de groupe contrôle de standard de soins...Quelle honte pour la recherche,
pubmed.ncbi.nlm.nih.gov/39470698/
Maintenant, vous pouvez passer des papiers ou des gens font mumuse avec des joujous, sans s’embarrasser de groupe contrôle de standard de soins...Quelle honte pour la recherche,
pubmed.ncbi.nlm.nih.gov/39470698/
Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial - PubMed
URL: https://www.clinicaltrials.gov; Unique identifier: NCT05111613.
pubmed.ncbi.nlm.nih.gov
February 19, 2025 at 7:34 AM
Il fut un temps lointain où publier dans Circulation était le Graal en cardiologie.
Maintenant, vous pouvez passer des papiers ou des gens font mumuse avec des joujous, sans s’embarrasser de groupe contrôle de standard de soins...Quelle honte pour la recherche,
pubmed.ncbi.nlm.nih.gov/39470698/
Maintenant, vous pouvez passer des papiers ou des gens font mumuse avec des joujous, sans s’embarrasser de groupe contrôle de standard de soins...Quelle honte pour la recherche,
pubmed.ncbi.nlm.nih.gov/39470698/
Patient went directly to IR for catheter-directed thrombolysis after receiving PLT transfusion & being placed on a heparin drip. If you notice 👇, there is a catheter in the R pulmonary artery:
October 10, 2025 at 8:11 PM
Patient went directly to IR for catheter-directed thrombolysis after receiving PLT transfusion & being placed on a heparin drip. If you notice 👇, there is a catheter in the R pulmonary artery:
Today's Paper of the Day is:
Catheter-directed interventions for pulmonary embolism
https://criticalcarereviews.com/latest-evidence/paper-of-the-day
Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025
Catheter-directed interventions for pulmonary embolism
https://criticalcarereviews.com/latest-evidence/paper-of-the-day
Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025
April 1, 2025 at 7:38 AM
Today's Paper of the Day is:
Catheter-directed interventions for pulmonary embolism
https://criticalcarereviews.com/latest-evidence/paper-of-the-day
Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025
Catheter-directed interventions for pulmonary embolism
https://criticalcarereviews.com/latest-evidence/paper-of-the-day
Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025
Here, even if the patient does not receive any catheter-directed intervention, the hospitalists feel uncomfortable managing them outside the ICU
October 14, 2025 at 2:44 PM
Here, even if the patient does not receive any catheter-directed intervention, the hospitalists feel uncomfortable managing them outside the ICU
Just sent a patient w submassive PE to the cath lab, so timely "Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: systematic review and network meta-analysis"
https://www.cmaj.ca/content/195/24/e833
https://www.cmaj.ca/content/195/24/e833
September 2, 2023 at 2:01 AM
Just sent a patient w submassive PE to the cath lab, so timely "Catheter-directed thrombolysis compared with systemic thrombolysis and anticoagulation in patients with intermediate- or high-risk pulmonary embolism: systematic review and network meta-analysis"
https://www.cmaj.ca/content/195/24/e833
https://www.cmaj.ca/content/195/24/e833
Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism - Cureus: Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism Cureus
Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism - Cureus
Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism Cureus
news.google.com
May 12, 2025 at 9:47 PM
Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism - Cureus: Patent Foramen Ovale Closure With Catheter-Directed Thrombolysis in Acute Pulmonary Embolism Cureus
In patients with pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis led to a lower risk of a composite of major adverse outcomes than anticoagulation alone. Full HI-PEITHO trial results: nej.md/4uMu4lv
#ACC26 | @accintouch.bsky.social
#ACC26 | @accintouch.bsky.social
March 28, 2026 at 2:39 PM
In patients with pulmonary embolism, ultrasound-facilitated, catheter-directed fibrinolysis led to a lower risk of a composite of major adverse outcomes than anticoagulation alone. Full HI-PEITHO trial results: nej.md/4uMu4lv
#ACC26 | @accintouch.bsky.social
#ACC26 | @accintouch.bsky.social
HI-PEITHO: For patients with pulmonary embolism, whether ultrasound-facilitated, catheter-directed fibrinolysis improves outcomes is unclear. Research evaluating this treatment plus anticoagulation as compared with anticoagulation alone is summarized in a new Quick Take video. https://nej.md/4nSvs2N
May 28, 2026 at 7:00 PM
HI-PEITHO: For patients with pulmonary embolism, whether ultrasound-facilitated, catheter-directed fibrinolysis improves outcomes is unclear. Research evaluating this treatment plus anticoagulation as compared with anticoagulation alone is summarized in a new Quick Take video. https://nej.md/4nSvs2N
Just heparin drip
t-PA/TNK
Catheter-directed thrombolysis
Suction thrombectomy
Surgery
t-PA/TNK
Catheter-directed thrombolysis
Suction thrombectomy
Surgery
October 10, 2025 at 8:11 PM
Just heparin drip
t-PA/TNK
Catheter-directed thrombolysis
Suction thrombectomy
Surgery
t-PA/TNK
Catheter-directed thrombolysis
Suction thrombectomy
Surgery
From #ESCCongress 2026: Patients with intermediate-high-risk acute pulmonary embolism may benefit from receiving catheter-directed thrombolysis with alteplase in addition to anticoagulation therapy.
👉️ buff.ly/EoCnO90
#MedNews #CardioSky
👉️ buff.ly/EoCnO90
#MedNews #CardioSky
Catheter-directed thrombolysis beats anticoagulation alone in intermediate-high-risk PE
Patients with intermediate-high-risk acute pulmonary embolism may benefit from receiving catheter-directed thrombolysis with alteplase in addition to anticoagulation therapy.
www.springermedicine.com
September 5, 2026 at 10:54 AM
From #ESCCongress 2026: Patients with intermediate-high-risk acute pulmonary embolism may benefit from receiving catheter-directed thrombolysis with alteplase in addition to anticoagulation therapy.
👉️ buff.ly/EoCnO90
#MedNews #CardioSky
👉️ buff.ly/EoCnO90
#MedNews #CardioSky
💡 My Takeaway: 18mg of Alteplase is a viable strategy for treating intermediate high risk PE with anticoagulation unrelated to catheter directed approach.
📚 I’ve added the full protocol & Josh Farkas's review to my open-access ICU Cheat Sheet. Get it here 👇
📚 I’ve added the full protocol & Josh Farkas's review to my open-access ICU Cheat Sheet. Get it here 👇
Landmark Studies in Critical Care Medicine
Landmark Studies in Critical Care Medicine 🫁 Pulmonary & Respiratory Medicine Acute Respiratory Distress Syndrome (ARDS) ARMA (Ventilation with Lower Tidal Volumes - 2000): Showed a significant mortal...
docs.google.com
March 31, 2026 at 5:51 PM
💡 My Takeaway: 18mg of Alteplase is a viable strategy for treating intermediate high risk PE with anticoagulation unrelated to catheter directed approach.
📚 I’ve added the full protocol & Josh Farkas's review to my open-access ICU Cheat Sheet. Get it here 👇
📚 I’ve added the full protocol & Josh Farkas's review to my open-access ICU Cheat Sheet. Get it here 👇