Catheter Direct Thrombolysis as a Modality of Management for Pulmonary Embolism: Risk Stratifying with the Pulmonary Embolism Severity Index

Catheter Directed Thrombolysis (CDT) or Systemic Thrombolysis (ST) are current standards of care for patients experiencing a Massive (MPE) or Submassive (SPE) Pulmonary Embolism which are categories that are defined by AHA guidelines for the Emergency Department. The Pulmonary Embolism Severity Index (PESI), a five-tier system, is a composite metric that can risk stratify PE into low risk (tiers 1,2) for SPE and high risk (tiers 3,4,5) for MPE, predicting mortality and outcomes. This study aims to determine if CDT or ST/no intervention (ST/NI) has better outcomes for MPE and SPE patients, while using PESI as a risk stratification tool. We conducted a retrospective analysis of patients from 2010 – 2016 who underwent CDT or ST/NI, matching patients using ten variables to yield N= 336: with equal proportions receiving CDT and ST/NI. 96 patients were in the low risk PESI group and 240 patients were in the high risk PESI group. In both low and high risk PESI groups, CDT intervention was associated with longer length of stay, (