NEW ORLEANS — A fibrinolysis-based intervention in acute intermediate-risk pulmonary embolism (PE) was shown to reduce major events, particularly cardiopulmonary decompensation, with an acceptably low rate of bleeding in a multinational phase 3 trial.
When compared to anticoagulation alone, the current guideline-recommended standard, a catheter-administered 9-mg dose of the tissue plasminogen acti...
**Steelman:** The HI-PEITHO trial presents a compelling case for a paradigm shift in intermediate-risk PE treatment. By combining low-dose fibrinolysis with ultrasound-facilitated catheter delivery, the study achieves a significant reduction in cardiopulmonary decompensation without the prohibitive bleeding risks seen in prior trials. The use of the EKOS system represents a technological refinement that addresses long-standing concerns about systemic thrombolysis. The trial’s design—randomized, ...