{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:23:22Z","timestamp":1785432202108,"version":"3.56.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"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":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>In patients with intermediate-risk pulmonary embolism (PE), there are limited tools to assess therapeutic response following catheter-based intervention. This study evaluates pulmonary vascular resistance (PVR), an invasive marker of right ventricular (RV) afterload, and its prognostic significance in acute PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This single-centre retrospective study included patients from October 2020\u2013May 2025 with intermediate-high risk PE undergoing large bore mechanical thrombectomy (LBMT) with pulmonary artery catheter-derived haemodynamic indices obtained pre- and post-procedure. The primary objective was to evaluate the effect of LBMT on PVR. The secondary objective was to evaluate the predictors of post-procedure elevated PVR (defined as PVR &amp;gt;2 Wood units, WU) and its effect on clinical composite outcome (PE mortality, resuscitated cardiac arrest, haemodynamic instability, and 90-day hospital readmission) and hospital length of stay (LOS). A total of 131 patients were included. Following LBMT, median PVR decreased significantly from 2.9 to 1.8 WU (P &amp;lt; 0.001), with greater reduction in patients with higher baseline PVR (baseline PVR tertile 3 to 1: 50% vs. 40% vs. 20%; P &amp;lt; 0.001). Persistently elevated post-procedure PVR (&amp;gt;2 WU) was seen in 44% of patients. However, the incidence of post-procedure severe PVR &amp;gt;5 WU was extremely low (11.5% pre-procedure, 0.8% post-procedure). Multivariable predictors of elevated post-procedural PVR were pre-procedural mean pulmonary artery pressure (OR: 1.07, 95% CI 1.01\u20131.14, P = 0.026) and pre-procedural PVR (OR 2.20, 95% CI: 1.20\u20134.04, P = 0.011). In an age and sex adjusted model, elevated post-procedure PVR was associated with a longer in-hospital LOS of 4.2 days (95% CI: 0.60\u20137.88; P = 0.023) and a 4-fold higher risk of the composite outcome (20.7% vs. 5.3%, adjusted hazard ratio: 4.02, 95% CI: 1.28\u201312.61, P = 0.017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with intermediate-high risk PE, LBMT significantly reduced PVR and may be a valuable haemodynamic marker of disease severity and treatment response. Elevated post-procedural PVR identified patients at increased risk of adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjacc\/zuag016","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:45:04Z","timestamp":1769604304000},"page":"297-306","source":"Crossref","is-referenced-by-count":2,"title":["Effect of large bore mechanical thrombectomy on pulmonary vascular resistance in patients with acute pulmonary embolism"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7946-6094","authenticated-orcid":false,"given":"Robert S","family":"Zhang","sequence":"first","affiliation":[{"name":"Division of Cardiology, Weill Cornell Medicine , New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYU Grossman School of Medicine , New York, NY 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