Pulmonary Embolectomy

PE Risk Stratification

• Massive (high-risk) PE — haemodynamic instability with sustained hypotension, cardiac arrest, or obstructive shock; requires immediate intervention
• Intermediate-high-risk PE — haemodynamically stable with right ventricular dysfunction on imaging and elevated cardiac biomarkers; may warrant catheter intervention
• Low-risk PE — managed with anticoagulation alone, frequently as an outpatient

Catheter-Based Embolectomy

The FlowTriever system uses a large-bore catheter to mechanically extract thrombus from the main pulmonary arteries under fluoroscopic guidance. Catheter-directed thrombolysis, which delivers clot-dissolving medication directly to the pulmonary thrombus, is an alternative approach for patients who are not candidates for mechanical extraction.

Pulmonary Embolism Response Team (PERT)

A coordinated multidisciplinary assessment integrating cardiology, vascular medicine, haematology, and intensive care — ensuring the most appropriate treatment strategy is selected based on individual risk stratification and patient factors.

Chronic Thromboembolic Pulmonary Hypertension

Approximately 1–4% of PE patients develop chronic thromboembolic pulmonary hypertension (CTEPH) from incomplete clot resolution. Treatment options include pulmonary endarterectomy surgery and balloon pulmonary angioplasty.

After Treatment

• Anticoagulation duration determined by underlying risk factors (provoked vs. unprovoked PE)
• Echocardiography at follow-up to assess right ventricular recovery
• Screening for CTEPH if symptoms persist beyond 3 months
• Thrombophilia workup for unprovoked pulmonary embolism