Large-bore mechanical thrombectomy was feasible and safe in a real-world cohort of intermediate-high-risk and high-risk pulmonary embolism patients, associated with rapid clinical improvement and favourable hemodynamic outcomes with a low rate of major complications.
Large-bore mechanical thrombectomy achieved 100% technical success across all treated patients.
Early clinical improvement within 48 hours was observed in 71% of patients following LBMT.
The right ventricular to left ventricular (RV/LV) ratio significantly decreased after LBMT, indicating improved RV function.
The 30-day all-cause mortality rate was 13%, with all deaths occurring in patients who had presented with cardiac arrest.
No device-related deaths or cardiac injuries occurred, supporting the safety profile of LBMT in this cohort.
LBMT was used in patients with contraindications to thrombolysis and PE-induced cardiac arrest, expanding its applicability beyond standard reperfusion candidates.
This research suggests that a catheter-based procedure called large-bore mechanical thrombectomy (LBMT) — which uses a large tube inserted into blood vessels to physically remove blood clots from the lungs — can be performed successfully and safely in patients with serious pulmonary embolism (PE, or blood clots in the lungs). The study followed 24 patients treated at a single hospital in Denmark over about three years. These were among the sickest PE patients, including many who had gone into cardiac arrest or who could not receive clot-dissolving drugs (thrombolysis) due to medical contraindications. The procedure worked technically in every single patient, and about 7 in 10 showed clear clinical improvement within 48 hours. Importantly, a key measure of heart strain — the ratio of the right to left heart chamber size — improved significantly after the procedure, suggesting the heart was under less stress. Three patients (13%) died within 30 days, but all three had experienced cardiac arrest before the procedure, which is itself a very high-risk condition. No deaths were caused by the device itself, and no injuries to the heart from the procedure were recorded. This research suggests that LBMT may offer a useful treatment path for high-risk PE patients, particularly those who cannot receive standard clot-dissolving medications or who are in critical condition. This study matters because pulmonary embolism can be rapidly life-threatening, and treatment options for the most severe cases — especially when thrombolysis is not an option — are limited. These findings suggest that LBMT could be a viable alternative or additional tool for clinicians managing these emergencies, though the study was small and conducted at a single center, so larger studies would be needed to confirm these results more broadly.
Dragsbaek S, Overgaard A, Mølgaard H, Støttrup N, Nielsen-Kudsk J, Andersen A. (2026). Large-bore mechanical thrombectomy in intermediate-high and high-risk pulmonary embolism: a retrospective single-centre case series.. Scandinavian cardiovascular journal : SCJ. https://doi.org/10.1080/14017431.2026.2724613