{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:44:57Z","timestamp":1791474297461,"version":"4.3.4"},"reference-count":58,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Pulm. circ."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The optimal treatment strategy for patients with acute intermediate\u2013high\u2010risk pulmonary embolism (PE) remains uncertain. This randomized clinical trial (PRETHA) aimed to evaluate the efficacy and safety of percutaneous reperfusion therapies\u2014trans\u2010catheter thrombectomy and trans\u2010catheter thrombolysis\u2014compared with standard anticoagulation therapy. In this single\u2010center, prospective trial conducted between April 2020 and April 2022, 39 patients with acute intermediate\u2013high\u2010risk PE were randomly assigned (1:1:1) to receive trans\u2010catheter thrombectomy, trans\u2010catheter thrombolysis, or conservative medical therapy with anticoagulation. Echocardiographic, hemodynamic, and biomarker parameters were assessed at baseline, 48\u2009h, and at 1\u2010, 6\u2010, and 12\u2010month follow\u2010up. At 48\u2009h, both interventional groups demonstrated significant improvement in right ventricular (RV) function and pulmonary pressures. The RV\/LV ratio decreased by 0.3 (95% CI: 0.13\u20130.69;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0002) in the thrombectomy group and by 0.4 (95% CI: 0.12\u20130.96;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0002) in the thrombolysis group. Noninvasively measured systolic pulmonary artery pressure decreased by 29% in the thrombectomy group and by 39% in the thrombolysis group (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Significant reductions in direct systolic and mean pulmonary artery pressures were also observed (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.0002). However, at longer (1 to 12 months) follow\u2010up, all three treatment groups represent similar positive changes of echocardiographic parameters and cardio\u2010specific biomarkers independent of the treatment tactic chosen in the acute period. Functional capacity and quality of life were superior in the interventional groups compared with anticoagulation alone. The incidence of adverse events was highest in the thrombolysis group (38%), whereas thrombectomy and medical therapy demonstrated more favorable safety profiles. Percutaneous reperfusion therapies were associated with earlier improvements in hemodynamic and functional surrogate parameters compared with anticoagulation alone; however, at 1\u2010year follow\u2010up, echocardiographic measures and biomarkers of cardiac function were similar across all treatment groups. These findings should be interpreted as mechanistic and hypothesis\u2010generating.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70249","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T12:30:51Z","timestamp":1769517051000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Percutaneous Reperfusion Therapies vs. Anticoagulation in Patients With Acute Intermediate\u2010High\u2010Risk Pulmonary Embolism: The PRETHA Randomized Clinical Trial"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7180-2935","authenticated-orcid":false,"given":"Taida","family":"Ivanauskien\u0117","sequence":"first","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrius","family":"Ber\u016bk\u0161tis","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Burneikait\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelija","family":"Daubarait\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0578-1705","authenticated-orcid":false,"given":"Kast\u0117","family":"Ivanauskait\u0117","sequence":"additional","affiliation":[{"name":"Department of Psychology UVA Universiteit van Amsterdam Amsterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindaugas","family":"Mata\u010di\u016bnas","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giedrius","family":"Navickas","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasa","family":"K\u016bgien\u0117","sequence":"additional","affiliation":[{"name":"Vilnius University Hospital Santaros Klinikos Vilnius Lithuania"},{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcin","family":"Kurzyna","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education European Health Center Otwock  Warsaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sigita","family":"Glaveckait\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Cardiovascular Diseases, Institute of Clinical Medicine, Faculty of Medicine Vilnius University Vilnius 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