This Week’s Education of the Week covers Catheter Directed Thrombolysis for PE.

Have you ever had that patient with a Sub-massive pulmonary embolism being admitted to the ICU? Do you ever wonder what the best treatment for them may be or what you would want if you were the patient?

Catheter directed therapies for PE continue to become more attractive as options for treatment for clot removal and for clot lysis. For example, the high dose of Alteplase (t-PA) for catheter directed therapy is 1/4 of the dose of systemic Alteplase for PE. This is a discussion we should have with the ICU fellow when we activate the PERT team as it may change our decision for anticoagulation in the ED. For more on the topic, please see the attached PDF. Attached is also the Meta-analysis for catheter directed therapy against systemic anticoagulation for submassive PE.