Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE

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Abstract
BACKGROUND: Recent observational studies have suggested that early treatment (P =0.071). Mean pulmonary artery pressure decreased significantly more in patients receiving early thrombectomy (8.6±5.2 versus 5.8±5.0 mm Hg; P =0.006). The major adverse events rate was similar ( P =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. CONCLUSIONS: Early mechanical thrombectomy was associated with larger reductions in right ventricle–to–left 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. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT06062329.

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