Commentary: Early Versus Delayed Use of Ultrasound-Assisted Catheter-Directed Thrombolysis in Patients with Acute Submassive Pulmonary Embolism

Pulmonary embolism remains one of the major causes of morbidity and mortality in the United States. For patients with an intermediate-risk pulmonary embolism, Ultrasound-Assisted Catheter-Directed Thrombolysis (USAT) is a contemporary treatment modality that has emerged as a potential alternative to systemic thrombolysis and surgical embolectomy. Multiple studies have demonstrated the efficacy of USAT in reducing the thrombus burden and reversing right ventricular dysfunction in patients with an intermediate-risk pulmonary embolism. However, literature addressing the potential impact of an early catheter directed revascularization is lacking. A recent retrospective study carried out by Edla et al suggests that, compared to a delayed intervention, early USAT can improve recovery of pulmonary hemodynamics in patients with submassive pulmonary embolism and also reduce the overall in-hospital length of stay. This commentary provides a thorough analysis of the results of this study and revisits the existing information on ultrasoundassisted thrombolysis for acute pulmonary embolism.