{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:23:37Z","timestamp":1790195017234,"version":"4.1.0"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Recent observational studies have suggested that early treatment (&lt;12 hours from diagnosis) of intermediate risk pulmonary embolism (PE) with catheter-based therapies may reduce morbidity and mortality. However, the effect of early versus late mechanical thrombectomy on acute pulmonary hemodynamics and right ventricular mechanics is less well defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Patients enrolled in SYMPHONY-PE (Symphony Pulmonary Embolism) trial were divided into one of 2 groups based on the time from baseline computed tomography pulmonary angiography to mechanical thrombectomy: Early &lt;12 hours versus late \u226512 hours. The primary safety end point was the rate of major adverse events within 48 hours, as adjudicated by an academic independent safety board. The primary efficacy end point was the core-lab assessed mean change in right ventricle\u2013to\u2013left ventricle ratio from baseline to 48 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Early thrombectomy was performed in 44% (48\/109) of patients and was associated with a larger reduction, approaching statistical significance, in right ventricle\u2013to\u2013left ventricle ratio (0.52\u00b10.50 versus 0.37\u00b10.34;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.071). Mean pulmonary artery pressure decreased significantly more in patients receiving early thrombectomy (8.6\u00b15.2 versus 5.8\u00b15.0 mm\u2009Hg;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.006). The major adverse events rate was similar (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.431) between groups, and there were no mortalities. The differences in efficacy outcomes were greatest in higher-risk patients per the Composite Pulmonary Embolism Shock score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Early mechanical thrombectomy was associated with larger reductions in right ventricle\u2013to\u2013left ventricle ratio and mean pulmonary artery pressure, with no significant differences in safety event rates compared with patients who underwent late thrombectomy. Randomized trials are needed to test these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT06062329.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.126.016573","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:00:34Z","timestamp":1781773234000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct06062329","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9485-0652","authenticated-orcid":true,"given":"Sripal","family":"Bangalore","sequence":"first","affiliation":[{"name":"Division of Cardiology, NYU Langone Health (S. Bangalore)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Dana","family":"Tomalty","sequence":"additional","affiliation":[{"name":"Huntsville Hospital, AL (R.D.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman","family":"Kado","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Corewell Health William Beaumont Hospital, Royal Oak, MI (H.K., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4979-6107","authenticated-orcid":true,"given":"Sameh","family":"Sayfo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Baylor Scott and White, The Heart Hospital, Plano, TX (S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Raskin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Mercy Heart Institute, Inc., Cincinnati, OH (A.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0607-1240","authenticated-orcid":true,"given":"Arman","family":"Qamar","sequence":"additional","affiliation":[{"name":"Division of Interventional Cardiology and Vascular Medicine, Endeavor Health (NorthShore University HealthSystem), Glenbrook Hospital, Glenview, IL (A.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Vargas Estrada","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tallahassee Memorial Hospital, Tallahassee Research Institute, Inc., (A.V.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9877-1334","authenticated-orcid":true,"given":"Kirema","family":"Garcia-Reyes","sequence":"additional","affiliation":[{"name":"Department of Diagnostic, Molecular, and Interventional Radiology, Mount Sinai Health System, NY (K.G.-R., V.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Gabriel","family":"Lipshutz","sequence":"additional","affiliation":[{"name":"Division of Interventional Radiology, Cedars Sinai Medical Center, Los Angeles, CA (H.G.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Yallapragada","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical City Dallas, TX (S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabah","family":"Butty","sequence":"additional","affiliation":[{"name":"Department of Radiology, Indiana University, Indianapolis (S. Butty)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery, Prisma Health, Greenville, SC (S.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1366-3906","authenticated-orcid":true,"given":"David","family":"Dexter","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Sentara, Norfolk, VA (D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7115-8719","authenticated-orcid":true,"given":"Justin","family":"Trivax","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Corewell Health William Beaumont Hospital, Royal Oak, MI (H.K., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhan","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical City Fort Worth, Fort Worth, TX (F.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Knox","sequence":"additional","affiliation":[{"name":"Advanced Radiology Services, Interventional Radiology, Corewell Health West, Grand Rapids, MI (M.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ramos","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery and Endovascular Therapy, Emory University, Atlanta, GA (C.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Al-Saghir","sequence":"additional","affiliation":[{"name":"First Coast Cardiovascular Institute, Jacksonville, FL (Y.A.-S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Bishay","sequence":"additional","affiliation":[{"name":"Department of Diagnostic, Molecular, and Interventional Radiology, Mount Sinai Health System, NY (K.G.-R., V.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2014.08.014"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001309"},{"key":"e_1_3_3_5_2","unstructured":"American Heart Association. 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