2021 Mar 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.
Pulmonary embolism (PE) is the third most common cause of cardiovascular death in the United States of America. It is one of the most common causes of death worldwide. Many patients die within the first few hours of presentation, making an early diagnosis and treatment paramount to survival. Pulmonary embolisms are categorized into three main risk categories: low risk, intermediate (sub-massive), and high risk (massive). Submassive PEs are further sub-divided into intermediate-high and intermediate-low risk PEs. Catheter-directed thrombolysis (CDT) is one of the newest treatment options for massive and submassive pulmonary embolisms with hemodynamic instability. CDT involves the infusion of a thrombolytic agent intravascularly adjacent to the clot burden through a percutaneous transcatheter. This article will review the anatomy involved in the pathology of pulmonary embolisms, indications for CDT, contraindications for CDT, an overview of the CDT procedural technique, possible complications of CDT, and the clinical significance of CDT for PE.