{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T18:39:23Z","timestamp":1794335963310,"version":"4.9.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,8,23]],"date-time":"2025-08-23T00:00:00Z","timestamp":1755907200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Catheter-based therapies for pulmonary embolism (PE), including endovascular mechanical thrombectomy (MT) and catheter-directed thrombolysis (CDT), are increasingly being used in clinical practice. However, real-world comparative data between these two modalities are scarce. We aimed to evaluate and compare the outcomes of MT and CDT in patients with PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This retrospective cohort study utilized the 2021 National Readmission Database (NRD) to identify adults with a primary diagnosis of PE who underwent either MT or CDT. The primary outcome was in-hospital mortality, while secondary outcomes included major bleeding, cardiac arrest, vascular complications, and post-discharge readmissions. Propensity-score matching was applied, followed by logistic and Cox-proportional hazard regression analyses. Subgroup analyses were conducted based on hospital procedural volume. After propensity-score matching, 7376 patients who underwent MT and 7355 who underwent CDT were included. MT was associated with higher odds of in-hospital mortality (4.4% vs. 3.4%; OR: 1.31, 95% CI: 1.01\u20131.68; P = 0.04) and major bleeding (6.3% vs. 3.6%; OR: 1.79, 95% CI: 1.39\u20132.32; P &amp;lt; 0.001) compared with CDT. No significant differences were observed in post-discharge mortality, although all-cause readmissions were higher in the MT group. Higher hospital procedural volumes were associated with lower in-hospital mortality and lower major bleeding rates in both MT and CDT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Endovascular CDT was associated with lower in-hospital mortality and major bleeding compared to MT in PE. As hospital procedural volume increased, both these outcomes improved, while difference in outcomes between MT and CDT reduced.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuaf110","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:37:44Z","timestamp":1755862664000},"page":"711-719","source":"Crossref","is-referenced-by-count":2,"title":["Endovascular mechanical thrombectomy vs. catheter-directed thrombolysis in pulmonary embolism: insights from the National Readmission Database"],"prefix":"10.1093","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-5878","authenticated-orcid":false,"given":"Monil","family":"Majmundar","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Kansas Medical Center , 3901 Rainbow Blvd 27 Mailstop 4023, Kansas City, KS 66160 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vidit","family":"Majmundar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Saint Vincent Hospital , Worcester, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4363-1550","authenticated-orcid":false,"given":"Vivek","family":"Bhat","sequence":"additional","affiliation":[{"name":"Department of Medicine, SUNY Upstate Medical University , Syracuse, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal N","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Kansas Medical Center , 3901 Rainbow Blvd 27 Mailstop 4023, Kansas City, KS 66160 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Parmar","sequence":"additional","affiliation":[{"name":"Section of Vascular Medicine, Massachusetts General Hospital , Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Alli","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Rohr","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Kansas Medical Center , Kansas City, KS ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Monteleone","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University of Texas at Austin, Dell Medical School , Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3438-7034","authenticated-orcid":false,"given":"Sanjum S","family":"Sethi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Columbia University Irving Medical Center , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2440-9033","authenticated-orcid":false,"given":"Kamal","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Kansas Medical Center , 3901 Rainbow Blvd 27 Mailstop 4023, Kansas City, KS 66160 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,23]]},"reference":[{"key":"2026031015540178100_zuaf110-B1","doi-asserted-by":"crossref","first-page":"e153","DOI":"10.1161\/CIR.0000000000001052","article-title":"Heart disease and stroke statistics\u20142022 update: a report from the American Heart 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