Low Dose Catheter Directed Thrombolysis for Acute Pulmonary Embolism

Inclusion Criteria: ‐ Age > 17 and < 81 years ‐ Debut of symptoms <14 days ‐ Acute symptomatic Intermediate‐high risk PE (according to 2014 ESC guidelines) confirmed by CTA with the embolus located in at least one proximal lower lobe or main pulmonary artery. ‐ Right‐to‐left ventricular dimension ratio >1.0 on CTA or TTE Exclusion Criteria: ‐ Significant bleeding risk or other contraindications to CDT or UFH* ‐ Not possible to perform CDT within 48 h after diagnosis ‐ Pregnancy ‐ Cardiac arrest requiring cardiopulmonary resuscitation ‐ Life expectancy < 120 days ‐ Altered mental status such that the patient is unable to provide informed consent ‐ Suspected or known chronic thromboembolic pulmonary hypertension ‐ Sustained hypertension (>180 mmHg systolic and/or >105 mmHg diastolic)