Lesson 23 • 17 Jan 2025
Proximal Thrombus Aspiration: Mechanical Adjuncts, Organized Clot, and Device Inventory
Course overview
This course reviews the clinical guidelines for acute pulmonary embolism, from risk stratification and the five updated clinical categories to the selection and technique of catheter-based therapies. Lessons cover triaging response team calls, interpreting right ventricular function, anticoagulation choices, procedural endpoints, and the evolving evidence for thrombolysis and thrombectomy. Additional topics address response team design, the operationalization of randomized trials, and strategies for distinguishing acute from chronic clot in complex cases. Learn from Drs. Sanjum Sethi, Jay Giri, Trevor Cummings, Timothy Fernandes, Robert Lookstein, Hady Lichaa, Michael Barraza, and Harris Chengazi.
2.5 hours, 24 lessons
Lessons
Advances in PE Risk Stratification and Catheter-Based Therapies
Lesson 1
Lesson 2
Defining the New PE Clinical Categories: A through E
Lesson 3
PERT Consultation: Hemodynamics, Thrombus Burden, and Clot Chronicity
Lesson 4
Echocardiographic Clues for Surgical Referral: Clot in Transit, PFO, and Systemic Thrombolysis
Lesson 5
Assessing Discordant RV and Biomarker Findings: RV Evaluation and the PE-TRACT Trial
Lesson 6
Heparin Selection and Criteria for Catheter-Directed Thrombolysis versus Thrombectomy
Lesson 7
Catheter Platforms for Thrombolysis: Lytic Dose Reduction and Right Heart Catheterization
Lesson 8
Selecting Thrombectomy Catheters: Design, Diameter, and Anatomical Constraints
Lesson 9
Proximal Thrombus Aspiration: Mechanical Adjuncts, Organized Clot, and Device Inventory
Response Team Formation, Device Innovation, and Guideline Implementation in Acute PE
Lesson 10
Launching a PE Response Team: Stakeholders, Specialty Roles, and Early Device Experience
Lesson 11
Lesson 12
Scope of the AHA/ACC Guideline: Rationale for the Five-Category PE Classification
Lesson 13
Applying Risk Categories B and C: Defining C1, Early Discharge, and Outpatient Follow-Up
Lesson 14
Identifying Category D PE: Hypotension, Venous Lactate, and HI-PEITHO Evidence
Lesson 15
Running a PE Response Team: Consultation Models, Activation, and Team Communication
Lesson 16
Ongoing PE Trials and National Intervention Trends through 2028
PE Severity Assessment, Procedural Endpoints, and Management of Complex and Chronic PE
Lesson 17
Staffing a PE Response Team: Specialty Constraints and Automated Case Detection
Lesson 18
Comparing Severity Scores: CPES and the New Risk Categories
Lesson 19
Differentiating Acute from Chronic PE: Clinical History, CT, and CTEPH Referral
Lesson 20
Escalating Support in Severe PE: Biomarker Trends, Imaging, and ECMO Criteria
Lesson 21
Trial Design and Endpoints: STORM PE, HI-PEITHO, and Data-Driven Guidelines
Lesson 22
Procedural Endpoints in PE: Prioritizing Hemodynamics over Angiographic Clearance
Lesson 23
Recognizing Chronic Thrombus Intraoperatively: Device Use and Pulmonary Artery Pressure
Lesson 24
Anticoagulation Trials in Intermediate-High Risk PE and Measuring Functional Recovery
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