Skip to main content
SpringerLink
Log in

Catheter-Directed Thrombolysis of Pulmonary Embolism

  • Chapter
  • First Online:
Current Management of Venous Diseases

  • 2026 Accesses

Abstract

The treatment of intermediate- and high-risk pulmonary embolism (PE) is experiencing dramatic changes given the ineligibility of many patients for systemic thrombolysis and the potential associated complications. Catheter-directed interventions (CDIs) are increasingly performed for acute PE as they are presumed to provide similar therapeutic benefits compared to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This chapter reviews catheter-directed interventions for acute PE including the indications, available techniques, clinical effectiveness, complication rates, and long-term outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Kahn SR, Houweling AH, Granton J, Rudski L, Dennie C, Hirsch A. Long-term outcomes after pulmonary embolism: current knowledge and future research. Blood Coagul Fibrinolysis. 2014;25(5):407–15. https://doi.org/10.1097/MBC.0000000000000070.

    Article  PubMed  Google Scholar 

  2. Huang W, Goldberg RJ, Anderson FA, Kiefe CI, Spencer FA. Secular trends in occurrence of acute venous thromboembolism: the Worcester VTE study (1985-2009). Am J Med. 2014;127(9):829–39.e5. https://doi.org/10.1016/j.amjmed.2014.03.041.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Avgerinos ED, Chaer RA. Catheter-directed interventions for acute pulmonary embolism. J Vasc Surg. 2015;61(2):559–65. https://doi.org/10.1016/j.jvs.2014.10.036.

    Article  PubMed  Google Scholar 

  4. Stein PD, Beemath A, Matta F, et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med. 2007;120(10):871–9. https://doi.org/10.1016/j.amjmed.2007.03.024.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Condliffe R, Kiely DG, Gibbs JSR, et al. Prognostic and aetiological factors in chronic thromboembolic pulmonary hypertension. Eur Respir J. 2009;33(2):332–8. https://doi.org/10.1183/09031936.00092008.

    Article  CAS  PubMed  Google Scholar 

  6. Klok FA, Mos ICM, Huisman MV. Brain-type natriuretic peptide levels in the prediction of adverse outcome in patients with pulmonary embolism: a systematic review and meta-analysis. Am J Respir Crit Care Med. 2008;178(4):425–30. https://doi.org/10.1164/rccm.200803-459OC.

    Article  PubMed  Google Scholar 

  7. Kaeberich A, Seeber V, Jimenez D, et al. Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism. Eur Respir J. 2015;45(5):1323–31. https://doi.org/10.1183/09031936.00174514.

    Article  CAS  PubMed  Google Scholar 

  8. Lankeit M, Jimenez D, Kostrubiec M, et al. Validation of N-terminal pro-brain natriuretic peptide cut-off values for risk stratification of pulmonary embolism. Eur Respir J. 2014;43(6):1669–77. https://doi.org/10.1183/09031936.00211613.

    Article  CAS  PubMed  Google Scholar 

  9. ten Wolde M, Sohne M, Quak E, Mac Gillavry MR, Buller HR. Prognostic value of echocardiographically assessed right ventricular dysfunction in patients with pulmonary embolism. Arch Intern Med. 2004;164(15):1685–9. https://doi.org/10.1001/archinte.164.15.1685.

    Article  PubMed  Google Scholar 

  10. Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: a predictor of early death in acute pulmonary embolism. Circulation. 2004;110(20):3276–80. https://doi.org/10.1161/01.CIR.0000147612.59751.4C.

    Article  PubMed  Google Scholar 

  11. Shafiq Q, Moukarbel GV, Gupta R, Hernandez D-A, Khouri SJ. Practical echocardiographic approach for risk stratification of patients with acute pulmonary embolism. J Echocardiogr. 2016;14(4):146–55. https://doi.org/10.1007/s12574-016-0306-4.

    Article  PubMed  Google Scholar 

  12. Konstantinides SV. 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J. 2014;35(45):3145–6. https://doi.org/10.1093/eurheartj/ehu393.

    Article  PubMed  Google Scholar 

  13. Goldhaber SZ, Visani L, De Rosa M. Acute pulmonary embolism: clinical outcomes in the international cooperative pulmonary embolism registry (ICOPER). Lancet. 1999;353(9162):1386–9. https://doi.org/10.1016/S0140-6736(98)07534-5.

    Article  CAS  PubMed  Google Scholar 

  14. Stein PD, Hull RD. Multidetector computed tomography for the diagnosis of acute pulmonary embolism. Curr Opin Pulm Med. 2007;13(5):384–8. https://doi.org/10.1097/MCP.0b013e32821acdbe.

    Article  PubMed  Google Scholar 

  15. Stein PD, Kayali F, Hull RD. Spiral computed tomography for the diagnosis of acute pulmonary embolism. Thromb Haemost. 2007;98(4):713–20.

    CAS  PubMed  Google Scholar 

  16. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354(22):2317–27. https://doi.org/10.1056/NEJMoa052367.

    Article  CAS  PubMed  Google Scholar 

  17. Anderson DR, Kahn SR, Rodger MA, et al. Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. JAMA. 2007;298(23):2743–53. https://doi.org/10.1001/jama.298.23.2743.

    Article  CAS  PubMed  Google Scholar 

  18. Righini M, Le Gal G, Aujesky D, et al. Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial. Lancet. 2008;371(9621):1343–52. https://doi.org/10.1016/S0140-6736 (08)60594-2.

    Article  PubMed  Google Scholar 

  19. Piazza G, Hohlfelder B, Jaff MR, et al. A prospective, single-arm, multicenter trial of ultrasound-facilitated, catheter-directed, low-dose fibrinolysis for acute massive and submassive pulmonary embolism: the SEATTLE II study. JACC Cardiovasc Interv. 2015;8(10):1382–92. https://doi.org/10.1016/j.jcin.2015.04.020.

    Article  PubMed  Google Scholar 

  20. Miller GAH, Sutton GC, Kerr IH, Gibson RV, Honey M. Comparison of streptokinase and heparin in treatment of isolated acute massive pulmonary embolism. Br Med J. 1971;2(5763):681–4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1796248/.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Jaff MR, McMurtry MS, Archer SL, et al. Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation. 2011;123(16):1788–830. https://doi.org/10.1161/CIR.0b013e318214914f.

    Article  PubMed  Google Scholar 

  22. Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016;149(2):315–52. https://doi.org/10.1016/j.chest.2015.11.026.

    Article  PubMed  Google Scholar 

  23. Bova C, Pesavento R, Marchiori A, et al. Risk stratification and outcomes in hemodynamically stable patients with acute pulmonary embolism: a prospective, multicentre, cohort study with three months of follow-up. J Thromb Haemost. 2009;7(6):938–44. https://doi.org/10.1111/j.1538-7836.2009.03345.x.

    Article  CAS  PubMed  Google Scholar 

  24. Becattini C, Agnelli G. Predictors of mortality from pulmonary embolism and their influence on clinical management. Thromb Haemost. 2008;100(5):747–51.

    CAS  PubMed  Google Scholar 

  25. Lobo JL, Zorrilla V, Aizpuru F, et al. Clinical syndromes and clinical outcome in patients with pulmonary embolism: findings from the RIETE registry. Chest. 2006;130(6):1817–22. https://doi.org/10.1378/chest.130.6.1817.

    Article  PubMed  Google Scholar 

  26. Becattini C, Agnelli G, Lankeit M, et al. Acute pulmonary embolism: mortality prediction by the 2014 European Society of Cardiology risk stratification model. Eur Respir J. 2016;48(3):780–6. https://doi.org/10.1183/13993003.00024-2016.

    Article  PubMed  Google Scholar 

  27. Kasper W, Konstantinides S, Geibel A, et al. Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol. 1997;30(5):1165–71. https://doi.org/10.1016/S0735-1097(97)00319-7.

    Article  CAS  PubMed  Google Scholar 

  28. Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Massive pulmonary embolism. Circulation. 2006;113(4):577 LP–582. http://circ.ahajournals.org/content/113/4/577.abstract.

    Article  Google Scholar 

  29. Tamizifar B, Fereyduni F, Esfahani MA, Kheyri S. Comparing three clinical prediction rules for primarily predicting the 30-day mortality of patients with pulmonary embolism: the “simplified revised Geneva score,” the “original PESI,” and the “simplified PESI”. Adv Biomed Res. 2016;5:137. https://doi.org/10.4103/2277-9175.187372.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Moores L, Zamarro C, Gomez V, et al. Changes in PESI scores predict mortality in intermediate-risk patients with acute pulmonary embolism. Eur Respir J. 2013;41(2):354–9. https://doi.org/10.1183/09031936.00225011.

    Article  PubMed  Google Scholar 

  31. Jimenez D, Aujesky D, Moores L, et al. Simplification of the pulmonary embolism severity index for prognostication in patients with acute symptomatic pulmonary embolism. Arch Intern Med. 2010;170(15):1383–9. https://doi.org/10.1001/archinternmed.2010.199.

    Article  PubMed  Google Scholar 

  32. Aujesky D, Roy P-M, Le Manach CP, et al. Validation of a model to predict adverse outcomes in patients with pulmonary embolism. Eur Heart J. 2006;27(4):476–81. https://doi.org/10.1093/eurheartj/ehi588.

    Article  PubMed  Google Scholar 

  33. Marshall PS, Tapson V, Jimenez D. Controversies in the management of life-threatening pulmonary embolism. Semin Respir Crit Care Med. 2015;36(6):835–41. https://doi.org/10.1055/s-0035-1564733.

    Article  PubMed  Google Scholar 

  34. Kline JA, Steuerwald MT, Marchick MR, Hernandez-Nino J, Rose GA. Prospective evaluation of right ventricular function and functional status 6 months after acute submassive pulmonary embolism: frequency of persistent or subsequent elevation in estimated pulmonary artery pressure. Chest. 2009;136(5):1202–10. https://doi.org/10.1378/chest.08-2988.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Kline JA, Nordenholz KE, Courtney DM, et al. Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicenter double-blind, placebo-controlled randomized trial. J Thromb Haemost. 2014;12(4):459–68. https://doi.org/10.1111/jth.12521.

    Article  CAS  PubMed  Google Scholar 

  36. Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right-ventricular function and pulmonary perfusion. Lancet. 1993;341(8844):507–11.

    Article  CAS  PubMed  Google Scholar 

  37. Stein PD, Matta F. Thrombolytic therapy in unstable patients with acute pulmonary embolism: saves lives but underused. Am J Med. 2012;125(5):465–70. https://doi.org/10.1016/j.amjmed.2011.10.015.

    Article  PubMed  Google Scholar 

  38. Chatterjee S, Chakraborty A, Weinberg I, et al. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA. 2014;311(23):2414–21. https://doi.org/10.1001/jama.2014.5990.

    Article  PubMed  Google Scholar 

  39. Meyer G, Vicaut E, Danays T, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med. 2014;370(15):1402–11. https://doi.org/10.1056/NEJMoa1302097.

    Article  CAS  PubMed  Google Scholar 

  40. Chamsuddin A, Nazzal L, Kang B, et al. Catheter-directed thrombolysis with the Endowave system in the treatment of acute massive pulmonary embolism: a retrospective multicenter case series. J Vasc Interv Radiol. 2008;19(3):372–6. https://doi.org/10.1016/j.jvir.2007.10.019.

    Article  PubMed  Google Scholar 

  41. Dumantepe M, Uyar I, Teymen B, Ugur O, Enc Y. Improvements in pulmonary artery pressure and right ventricular function after ultrasound-accelerated catheter-directed thrombolysis for the treatment of pulmonary embolism. J Card Surg. 2014;29(4):455–63. https://doi.org/10.1111/jocs.12354.

    Article  PubMed  Google Scholar 

  42. Engelhardt TC. Catheter-directed ultrasound-accelerated thrombolysis for the treatment of acute pulmonary embolism. In: Urgent Interventional Therapies; 2014. doi:https://doi.org/10.1002/9781118504499.ch58.

  43. Engelberger RP, Moschovitis A, Fahrni J, et al. Fixed low-dose ultrasound-assisted catheter-directed thrombolysis for intermediate and high-risk pulmonary embolism. Eur Heart J. 2015;36(10):597–604. https://doi.org/10.1093/eurheartj/eht531.

    Article  PubMed  Google Scholar 

  44. Kennedy RJ, Kenney HH, Dunfee BL. Thrombus Resolution and hemodynamic recovery using ultrasound-accelerated thrombolysis in acute pulmonary embolism. J Vasc Interv Radiol. 2013;24(6):841–8. https://doi.org/10.1016/j.jvir.2013.02.023.

    Article  PubMed  Google Scholar 

  45. Lin PH, Annambhotla S, Bechara CF, et al. Comparison of percutaneous ultrasound-accelerated thrombolysis versus catheter-directed thrombolysis in patients with acute massive pulmonary embolism. Vascular. 2009;17:137–47. https://doi.org/10.2310/6670.2009.00063.

    Article  Google Scholar 

  46. Mostafa A, Briasoulis A, Telila T, Belgrave K, Grines C. Treatment of massive or submassive acute pulmonary embolism with catheter-directed thrombolysis. Am J Cardiol. 2016;117(6):1014–20. https://doi.org/10.1016/j.amjcard.2015.12.041.

    Article  PubMed  Google Scholar 

  47. Quintana D, Salsamendi J, Fourzali R, Narayanan G. Ultrasound-assisted thrombolysis in submassive and massive pulmonary embolism: assessment of lung obstruction before and after catheter-directed therapy. Cardiovasc Intervent Radiol. 2014;37(2):420–6. https://doi.org/10.1007/s00270-013-0696-x.

    Article  PubMed  Google Scholar 

  48. Patel NNNJ, Patel NNNJ, Agnihotri K, et al. Utilization of catheter-directed thrombolysis in pulmonary embolism and outcome difference between systemic thrombolysis and catheter-directed thrombolysis. Catheter Cardiovasc Interv. 2015;86(7):1219–27. https://doi.org/10.1002/ccd.26108.

    Article  PubMed  Google Scholar 

  49. Kucher N, Boekstegers P, Müller OJ, et al. Randomized, controlled trial of ultrasound-assisted catheter-directed thrombolysis for acute intermediate-risk pulmonary embolism. Circulation. 2014;129(4):479–86. https://doi.org/10.1161/CIRCULATIONAHA.113.005544.

    Article  PubMed  Google Scholar 

  50. Kuo WT, Gould MK, Louie JD, Rosenberg JK, Sze DY, Hofmann LV. Catheter-directed therapy for the treatment of massive pulmonary embolism: systematic review and meta-analysis of modern techniques. J Vasc Interv Radiol. 2009;20(11):1431–40. https://doi.org/10.1016/j.jvir.2009.08.002.

    Article  PubMed  Google Scholar 

  51. Avgerinos ED, Liang NL, El-Shazly OM, et al. Improved early right ventricular function recovery but increased complications with catheter-directed interventions compared with anticoagulation alone for submassive pulmonary embolism. J Vasc Surg Venous Lymphat Disord. 2016;4(3):268–75. https://doi.org/10.1016/j.jvsv.2015.11.003.

    Article  PubMed  Google Scholar 

  52. Kuo WT, Banerjee A, Kim PS, et al. Pulmonary embolism response to fragmentation, embolectomy, and catheter thrombolysis (PERFECT): Initial results from a prospective multicenter registry. Chest. 2015;148(3):667–73. https://doi.org/10.1378/chest.15-0119.

    Article  PubMed  Google Scholar 

  53. Kuo WT. Endovascular therapy for acute pulmonary embolism. J Vasc Interv Radiol. 2012;23(2):167–79.e4.; quiz 179. https://doi.org/10.1016/j.jvir.2011.10.012.

    Article  PubMed  Google Scholar 

  54. Avgerinos ED, Abou Ali AN, Liang NL, Genovese E, Singh MJ, Makaroun MS, Chaer R. Predictors of failure and complications of catheter directed interventions for pulmonary embolism. In: American venous forum 28th annual meeting. Orlando: Elsevier; 2016. p. 142.

    Google Scholar 

  55. George B, Wallace EL, Charnigo R, et al. A retrospective analysis of catheter-based thrombolytic therapy for acute submassive and massive pulmonary embolism. Vasc Med. 2015;20(2):122–30. https://doi.org/10.1177/1358863X14568135.

    Article  PubMed  Google Scholar 

  56. Bagla S, Smirniotopoulos JB, van Breda A, Sheridan MJ, Sterling KM. Ultrasound-accelerated catheter-directed thrombolysis for acute submassive pulmonary embolism. J Vasc Interv Radiol. 2015;26(7):1001–6. https://doi.org/10.1016/j.jvir.2014.12.017.

    Article  PubMed  Google Scholar 

  57. McCabe JM, Huang P-H, Riedl L, Eisenhauer AC, Sobieszczyk P. Usefulness and safety of ultrasound-assisted catheter-directed thrombolysis for submassive pulmonary emboli. Am J Cardiol. 2015;115(6):821–4. https://doi.org/10.1016/j.amjcard.2014.12.050.

    Article  PubMed  Google Scholar 

  58. Engelhardt TC, Taylor AJ, Simprini LA, Kucher N. Catheter-directed ultrasound-accelerated thrombolysis for the treatment of acute pulmonary embolism. Thromb Res. 2011;128(2):149–54. https://doi.org/10.1016/j.thromres.2011.05.014.

    Article  CAS  PubMed  Google Scholar 

  59. Liang NL, Chaer RA, Avgerinos ED. Catheter-directed interventions for acute pulmonary embolism: the jury is still out. Chest. 2015;148(3):e93. https://doi.org/10.1378/chest.15-1011.

    Article  PubMed  Google Scholar 

  60. Abou Ali AN, Liang NL, Chaer RA, Avgerinos ED. Catheter interventions for pulmonary embolism: are they really that safe? Am J Cardiol. 2016;118(2):307–8. https://doi.org/10.1016/j.amjcard.2016.03.030.

    Article  PubMed  Google Scholar 

  61. Optimum Duration of Acoustic Pulse Thrombolysis Procedure in Acute Pulmonary Embolism (OPTALYSE PE). https://clinicaltrials.gov/ct2/show/NCT02396758. Published 2016.

  62. Engelberger RP, Kucher N. Ultrasound-assisted thrombolysis for acute pulmonary embolism: a systematic review. Eur Heart J. 2014;35(12):758–64. https://doi.org/10.1093/eurheartj/ehu029.

    Article  PubMed  Google Scholar 

  63. Owens CA. Ultrasound-enhanced thrombolysis: EKOS EndoWave infusion catheter system. Semin Intervent Radiol. 2008;25(1):37–41. https://doi.org/10.1055/s-2008-1052304.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Liang NL, Avgerinos ED, Marone LK, Singh MJ, Makaroun MS, Chaer RA. Equivalent outcomes between ultrasound-assisted thrombolysis and standard catheter-directed thrombolysis for the treatment of acute pulmonary embolism. J Vasc Surg Venous Lymphat Disord. 2015;3(1):120–1. https://doi.org/10.1016/j.jvsv.2014.10.015.

    Article  CAS  PubMed  Google Scholar 

  65. Schmitz-Rode T, Janssens U, Schild HH, Basche S, Hanrath P, Gunther RW. Fragmentation of massive pulmonary embolism using a pigtail rotation catheter. Chest. 1998;114(5):1427–36.

    Article  CAS  PubMed  Google Scholar 

  66. Heberlein WE, Meek ME, Saleh O, Meek JC, Lensing SY, Culp WC. New generation aspiration catheter: feasibility in the treatment of pulmonary embolism. World J Radiol. 2013;5(11):430–5. https://doi.org/10.4329/wjr.v5.i11.430.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Al-Hakim R, Park J, Bansal A, Genshaft S, Moriarty JM. Early experience with AngioVac aspiration in the pulmonary arteries. J Vasc Interv Radiol. 2016;27(5):730–4. https://doi.org/10.1016/j.jvir.2016.01.012.

    Article  PubMed  Google Scholar 

  68. Weinberg AS, Dohad S, Ramzy D, Madyoon H, Tapson VF. Clot extraction with the FlowTriever device in acute massive pulmonary embolism. J Intensive Care Med. 2016;31(10):676–9. https://doi.org/10.1177/0885066616666031.

    Article  Google Scholar 

  69. Siablis D, Karnabatidis D, Katsanos K, Kagadis GC, Zabakis P, Hahalis G. AngioJet rheolytic thrombectomy versus local intrapulmonary thrombolysis in massive pulmonary embolism: a retrospective data analysis. J Endovasc Ther. 2005;12(2):206–14. https://doi.org/10.1583/04-1378.1.

    Article  PubMed  Google Scholar 

  70. Zeni PTJ, Blank BG, Peeler DW. Use of rheolytic thrombectomy in treatment of acute massive pulmonary embolism. J Vasc Interv Radiol. 2003;14(12):1511–5.

    Article  PubMed  Google Scholar 

  71. Zarrabi K, Zolghadrasli A, Ostovan MA, Azimifar A. Short-term results of retrograde pulmonary embolectomy in massive and submassive pulmonary embolism: a single-center study of 30 patients. Eur J Cardiothorac Surg. 2011;40(4):890–3. https://doi.org/10.1016/j.ejcts.2011.06.004.

    Article  PubMed  Google Scholar 

  72. Mismetti P, Laporte S, Pellerin O, et al. Effect of a retrievable inferior vena cava filter plus anticoagulation vs anticoagulation alone on risk of recurrent pulmonary embolism: a randomized clinical trial. JAMA. 2015;313(16):1627–35. https://doi.org/10.1001/jama.2015.3780.

    Article  PubMed  Google Scholar 

  73. Klok FA, van Kralingen KW, van Dijk APJ, Heyning FH, Vliegen HW, Huisman MV. Prospective cardiopulmonary screening program to detect chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. Haematologica. 2010;95(6):970–5. https://doi.org/10.3324/haematol.2009.018960.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Pengo V, Lensing AWA, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004;350(22):2257–64. https://doi.org/10.1056/NEJMoa032274.

    Article  CAS  PubMed  Google Scholar 

  75. Sharifi M, Bay C, Skrocki L, Rahimi F, Mehdipour M. Moderate pulmonary embolism treated with thrombolysis (from the “MOPETT” trial). Am J Cardiol. 2013;111(2):273–7. https://doi.org/10.1016/j.amjcard.2012.09.027.

    Article  PubMed  Google Scholar 

  76. Becattini C, Agnelli G, Pesavento R, et al. Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest. 2006;130(1):172–5. https://doi.org/10.1378/chest.130.1.172.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Division of Vascular Surgery, University of Pittsburgh Medical Center, 200 Lothrop Street, Suite A1011, Pittsburgh, PA, 15213, USA

    Adham Abou Ali MD, Efthymios D. Avgerinos MD, PhD & Rabih A. Chaer MD, MSc

Authors
  1. Adham Abou Ali MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Efthymios D. Avgerinos MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rabih A. Chaer MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rabih A. Chaer MD, MSc .

Editor information

Editors and Affiliations

  1. Section of Vascular Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA

    Cassius Iyad Ochoa Chaar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Abou Ali, A., Avgerinos, E.D., Chaer, R.A. (2018). Catheter-Directed Thrombolysis of Pulmonary Embolism. In: Chaar, C. (eds) Current Management of Venous Diseases . Springer, Cham. https://doi.org/10.1007/978-3-319-65226-9_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65226-9_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65225-2

  • Online ISBN: 978-3-319-65226-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation