CDMT in oncologic patients characterized an acceptable safety profile and substantial improvement in RV function, similar to those observed in nononcologic patients, with similar in-hospital survival rates between groups.
Active cancer was present in 18.3% of PE patients treated with catheter-directed mechanical thrombectomy in this multicenter registry.
Both oncologic and nononcologic patients demonstrated significant and similar reductions in RV/LV ratio 48 hours after CDMT.
Major bleeding rates were low and did not differ significantly between oncologic and nononcologic patients.
In-hospital all-cause mortality rates were numerically higher in oncologic patients but did not differ significantly from nononcologic patients.
Oncologic and nononcologic patients did not differ significantly in baseline characteristics.
This research suggests that a minimally invasive procedure called catheter-directed mechanical thrombectomy (CDMT) — which uses a catheter to physically remove blood clots from the lungs — works similarly well and safely in cancer patients as it does in patients without cancer. The study followed 290 people with serious pulmonary embolism (PE, or blood clots in the lungs) treated at multiple hospitals. About 18% of these patients had active cancer. Researchers measured heart strain before and 48 hours after the procedure and tracked complications including bleeding and in-hospital death. The findings showed that both cancer patients and non-cancer patients experienced roughly a 27% reduction in the strain on the right side of the heart after CDMT, and this improvement was statistically significant in both groups. Serious bleeding was rare in both groups (about 2% in cancer patients vs. less than 1% in non-cancer patients), and in-hospital death rates were similar (about 9% vs. 6%), with neither difference reaching statistical significance. This is notable because cancer patients are generally considered at higher risk for both bleeding and clotting complications. This research suggests that cancer should not automatically exclude patients from receiving CDMT for life-threatening pulmonary embolism. The procedure appeared to provide meaningful benefit with an acceptable risk profile even in this traditionally higher-risk population. These findings could help inform treatment decisions for the substantial number of cancer patients who develop serious pulmonary embolism, though larger studies would be needed to confirm these results.
Banaszkiewicz M, Sławek-Szmyt S, Stępniewski J, Kurzyna P, Klotzka A, Kuliczkowski W, et al.. (2026). Outcomes of catheter-directed mechanical thrombectomy in patients with cancer-associated pulmonary embolism: a multicenter, prospective registry.. Research and practice in thrombosis and haemostasis. https://doi.org/10.1016/j.rpth.2026.106883