July 11, 2023—Catheter-directed thrombolysis (CDT) appears to be a therapy associated with a lower risk of death and bleeding complications for high-risk pulmonary embolism patients, according to new research in CMAJ (Canadian Medical Association Journal).  

Pulmonary embolism (PE)—life-threatening blood clots in a lung—is the third leading cause of death from heart disease after myocardial infarction (heart attacks) and stroke. Early diagnosis is essential, as 1 in 3 deaths occur in the first few hours compared with only 7% of early deaths in properly diagnosed and treated cases.  

Catheter-directed thrombolysis is a procedure that infuses low doses of medication directly into the pulmonary arteries. Research on its safety and efficacy is lacking, and treatment guidelines vary because of this uncertainty. 

In a comparison of different treatments for pulmonary embolisms, Israeli researchers found that CDT was associated with a decreased risk of death and lower risks of major bleeding and brain bleeds. 

Dr. Bruria Hirsh Raccah, a researcher at the Hebrew University of Jerusalem and Hadassah University Medical Center and a co-author of the study, cautions that “further research is necessary before drawing definitive conclusions. However, the findings indicate that CDT should be considered the preferred treatment among eligible patients, given its safety and effectiveness, especially when compared to the higher toxicity of systemic thrombolysis.”  

“Centers that specialize in CDT can consider it as first-line therapy among patients with intermediate-to high-risk PE,” the research team concluded.  

It was co-authored by Bruria Hirsch Raccah, Stav Yanko, and other researchers from Hadassah Medical Center. 

To read the full research paper, please click here.