{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T17:01:00Z","timestamp":1764090060231,"version":"3.45.0"},"reference-count":11,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>High-risk pulmonary embolism (PE) is a life-threatening condition characterized by hemodynamic instability, often leading to catastrophic outcomes such as cardiac arrest and cardiogenic shock. We conducted a retrospective analysis of patients diagnosed with high-risk PE at a single tertiary center between 2018 and 2024. Catastrophic PE was defined as high-risk PE with hemodynamic collapse, including cardiac arrest and\/or the requirement for high-dose vasopressors. Data on clinical characteristics, treatments, and outcomes were analyzed. Catastrophic PE accounted for 59% of cases. Systemic thrombolysis was the most frequent reperfusion strategy (67%), while catheter-directed therapies (35.4%) and VA-ECMO (11.4%) were used selectively. Despite aggressive management, catastrophic PE exhibited significantly higher mortality rates at 7 days (40%) and 30 days (49%) compared to non-catastrophic cases (9% and 12.5%, respectively). These patients also showed higher rates of multiorgan failure and required more invasive support. This study underscores the importance of early recognition and tailored treatment strategies for catastrophic PE, highlighting its distinct clinical presentation and worse outcomes compared to non-catastrophic high-risk PE. Further research is essential to refine treatment protocols and improve survival in this critically ill population, emphasizing the utility of a standardized classification to enhance clinical management and research consistency.<\/jats:p>","DOI":"10.3390\/jcdd12120459","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T16:31:54Z","timestamp":1764088314000},"page":"459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Outcomes and Treatment Strategies in Catastrophic High-Risk Pulmonary Embolism: A Retrospective Analysis"],"prefix":"10.3390","volume":"12","author":[{"given":"Mar\u00eda Caridad","family":"Mata","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Hospital Cl\u00ednic de Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8938-7603","authenticated-orcid":false,"given":"Ignacio","family":"Espa\u00f1ol","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Hospital Cl\u00ednic de Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arantxa","family":"Gelabert","sequence":"additional","affiliation":[{"name":"Radiology Department, Centre de Diagn\u00f2stic per la Imatge, Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5415-3449","authenticated-orcid":false,"given":"Jes\u00fas","family":"Aibar","sequence":"additional","affiliation":[{"name":"Deparment of Internal Medicine, Institut Cl\u00ednic de Medicina i Dermatologia (ICMID), Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00faria","family":"Albacar","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Hospital Cl\u00ednic de Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"},{"name":"CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4242-5133","authenticated-orcid":false,"given":"Elena","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6118-8970","authenticated-orcid":false,"given":"Pedro","family":"Castro","sequence":"additional","affiliation":[{"name":"Deparment of Internal Medicine, Institut Cl\u00ednic de Medicina i Dermatologia (ICMID), Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"},{"name":"Medical Intensive Care Unit, Institut Cl\u00ednic de Medicina i Dermatologia (ICMID), Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S\u00f2nia","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Cl\u00ednic de Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3808-808X","authenticated-orcid":false,"given":"Jeisson","family":"Osorio","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Hospital Cl\u00ednic de Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"},{"name":"CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9504-7511","authenticated-orcid":false,"given":"Jorge","family":"Mois\u00e9s","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Hospital Cl\u00ednic de Barcelona, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain"},{"name":"CIBER of Respiratory Diseases (CIBERES), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Chopard, R., Behr, J., Vidoni, C., Ecarnot, F., and Meneveau, N. 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