{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:53:52Z","timestamp":1790279632730,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the clinical efficacy and safety of anticoagulation combined with catheter-directed urokinase (UK) thrombolysis vs. anticoagulation combined with catheter-directed alteplase (rt-PA) infusion thrombolysis in patients with intermediate-risk acute pulmonary embolism (APE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective analysis was conducted on intermediate-risk APE patients treated at our center between June 2022 and May 2025, all of whom received anticoagulation combined with catheter-directed thrombolysis. The UK group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200956) received continuous UK infusion via pulmonary artery catheter (400,000\u2013500,000 IU\/day for 2\u20133 days), while the rt-PA group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923) received intraprocedural rt-PA infusion (20\u2005mg\/30\u2005min). Changes in cardiac troponin I (cTnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), right ventricular diameter\/left ventricular diameter (RVD\/LVD), and pulmonary artery obstruction index (PAOI) were compared before and after treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics showed no significant differences between groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). Post-treatment, the UK group demonstrated significant improvements in PAOI, RVD\/LVD, NT-proBNP, and cTnI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), while the rt-PA group showed significant improvements in PAOI, RVD\/LVD, and cTnI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05) but not NT-proBNP (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.088). There were no statistically significant differences in the aforementioned indicators between the two groups at both pre-treatment and post-treatment time points (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05). There were no statistically significant differences in in-hospital mortality, the incidence of bleeding adverse events, and hospital stay duration between the two groups (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For intermediate-risk APE, catheter-directed UK thrombolysis and intraprocedural rt-PA infusion offer comparable efficacy and safety. However, the rt-PA regimen may be more advantageous due to its avoidance of prolonged catheter placement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1675768","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T06:28:12Z","timestamp":1767335292000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["A comparative study of anticoagulation combined with different catheter-directed thrombolysis strategies (urokinase catheter-directed vs. alteplase infusion) in the treatment of intermediate-risk pulmonary embolism"],"prefix":"10.3389","volume":"12","author":[{"given":"Jinqi","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qihong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","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","year":"2020","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1016\/S2213-2600(19)30354-6","article-title":"Trends in mortality related to pulmonary embolism in the European region, 2000\u201315: analysis of vital registration data from the WHO mortality database","volume":"8","author":"Barco","year":"2020","journal-title":"Lancet Respir Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"684","DOI":"10.33963\/KP.a2023.0143","article-title":"How to predict prognosis in patients with acute pulmonary embolism? 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