This retrospective US cohort compared catheter-directed intervention with anticoagulation for hospitalized intermediate-high risk pulmonary embolism, including 50,614 patients in short-term analyses. After overlap weighting, intervention was associated with lower 30-day mortality (adjusted HR 0.70; 95% CI 0.66–0.73). Among discharge survivors, intervention was associated with fewer heart-failure readmissions (aHR 0.79; 95% CI 0.75–0.83), respiratory-failure readmissions (0.85; 0.81–0.90), and less chronic oxygen use (0.69; 0.65–0.74). Post-discharge analyses included 49,122 patients; the abstract did not specify the duration of long-term follow-up.
Catheter-directed intervention was associated with lower mortality and post-discharge morbidity, but this observational comparison does not establish benefit. Randomized trials with long-term patient-centred outcomes are needed.
Study limitation: Residual confounding may explain associations despite weighting; bleeding results and the duration of post-discharge follow-up were not reported.
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