{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:03:20Z","timestamp":1784520200857,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Catheter\u2010directed treatment of pulmonary artery embolism (PE) is increasingly used worldwide. Numerous devices for mechanical thrombectomy (MT) and local fibrinolysis (LF) have become available over recent years. While various studies show safety and efficacy for either MT or LF, little is known about the combination of both treatment modalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This open\u2010label, single\u2010center, randomized controlled pilot trial aimed to investigate the treatment effect size and safety of a combined catheter\u2010interventional treatment (CCIT) approach for PE, consisting of LF and MT in comparison to conventional guideline\u2010directed therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty patients with intermediate\u2010high risk PE were randomized 2:1 to CCIT or control. The two co\u2010primary endpoints were the difference in (1) a combined clinical endpoint (consisting of systolic blood pressure over heart rate, and respiratory rate) and (2) right\u2010to\u2010left ventricular (RV\/LV)\u2010ratio from a transthoracic echocardiogram between the two groups 24\u2009h after randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 24\u2009h, the combined clinical endpoint improved by 0.02\u2009\u00b1\u20090.01 in the CCIT group, whereas no improvement was observed in the control group (\u22120.01\u2009\u00b1\u20090.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for between\u2010group comparison). RV\/LV\u2010ratio was reduced by 0.3\u2009\u00b1\u20090.2 in the CCIT\u2010group and remained unchanged in the control group (\u22120.1\u2009\u00b1\u20090.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02 for between\u2010group comparison). Safety outcomes, including in\u2010hospital mortality and bleeding, were similar between the two treatment groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this pilot study, CCIT of intermediate\u2010high risk PE was found to be effective and safe in comparison to conventional PE treatment. These findings warrant confirmation in larger\u2010scale trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70758","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T03:40:13Z","timestamp":1784518813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Randomized Pilot Trial Comparing Combined Catheter\u2010Interventional Treatment Versus Standard of Care in Intermediate High\u2010Risk Pulmonary Embolism"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2854-5501","authenticated-orcid":false,"given":"Parham","family":"Shahidi","sequence":"first","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Mentzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Sulimov","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Sagmeister","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Kister","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0169-998X","authenticated-orcid":false,"given":"Holger","family":"Thiele","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"von Roeder","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"P\u00f6ss","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Fengler","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Center Leipzig at Leipzig University Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"issue":"11","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"2363","DOI":"10.1161\/ATVBAHA.114.304488","article-title":"Thrombosis: A Major Contributor to Global Disease Burden","volume":"34","author":"Raskob G. 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A.","year":"2025","journal-title":"Circulation"},{"issue":"4","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration With the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides S. 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