{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:07:05Z","timestamp":1789470425853,"version":"build-2803163510"},"reference-count":20,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Dedicated pulmonary embolism (PE) thrombectomy devices are not universally available. We evaluated the early outcomes and safety of catheter-directed bolus thrombolysis plus manual aspiration thrombectomy (BT-MAT) using conventional catheters for intermediate-high- or high-risk acute PE. Methods: This retrospective, single-center, historical control study included adults with acute intermediate-high- or high-risk PE involving the main pulmonary artery. Patients who underwent BT-MAT from November 2023 to October 2025 were compared with historical controls who received conventional management such as anticoagulation or systemic thrombolysis before BT-MAT implementation (November 2022 to October 2023). BT-MAT comprised catheter-directed bolus alteplase injection followed by manual aspiration using conventional 7- to 8-Fr catheters or sheaths. Results: Twenty-three patients were included (BT-MAT, n = 11; historical control, n = 12). BT-MAT patients were younger (65.3 \u00b1 16.5 vs. 78.2 \u00b1 11.4 years; p = 0.040) and more frequently had bilateral main pulmonary artery involvement (82% vs. 33%; p = 0.036). Technical success was achieved in all BT-MAT procedures. Clinical success occurred in 11\/11 BT-MAT patients and 10\/12 conventional-treatment patients (100.0% vs. 83.3%; p = 0.478). No treatment-related complications occurred in the BT- MAT group, whereas two patients in the historical control group developed blood-tinged sputum and hematuria. Estimated right ventricular systolic pressure decreased from 47.1 \u00b1 8.6 to 36.2 \u00b1 10.1 mmHg after BT-MAT. Hospital stay did not differ significantly between groups. Conclusions: BT-MAT was technically feasible and showed favorable early clinical outcomes in this small series. Further prospective studies are warranted to evaluate its efficacy and safety.<\/jats:p>","DOI":"10.3390\/jcm15187157","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:32:01Z","timestamp":1789468321000},"page":"7157","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Outcomes of Bolus Thrombolysis Plus Manual Aspiration Thrombectomy Using Conventional Catheters for Intermediate-High- and High-Risk Acute Pulmonary Embolism"],"prefix":"10.3390","volume":"15","author":[{"given":"Gayoun","family":"Min","sequence":"first","affiliation":[{"name":"Department of Medicine, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-5483","authenticated-orcid":false,"given":"Wonju","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-2480","authenticated-orcid":false,"given":"Lyo Min","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Soo","family":"Do","sequence":"additional","affiliation":[{"name":"Department of Radiology, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0466-4600","authenticated-orcid":false,"given":"Hyunseung","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7004-6985","authenticated-orcid":false,"given":"Sunghoon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Ho","family":"Jo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyoung Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref_1","first-page":"101258","article-title":"Epidemiology of pulmonary embolism in China, 2021: A nationwide hospital-based study","volume":"54","author":"Zhen","year":"2025","journal-title":"Lancet Reg. 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