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Pall T. Onundarson: The 3-Decade Journey of Ultrasound-Enhanced Fibrinolysis in PE
Pall T. Onundarson/LinkedIn
May 31, 2026, 10:32

Pall T. Onundarson: The 3-Decade Journey of Ultrasound-Enhanced Fibrinolysis in PE

Pall T. Onundarson, Professor Emeritus at Landspitali University Hospital, shared a post on LinkedIn about a recent article by Kenneth Rosenfield et al, published in NEJM, adding:

”Interesting how late the fruits of research may bloom.

Back in 1990–1991, during my research fellowship at the University of Rochester Medical Center (Strong Memorial Hospital), I performed in vitro experiments that were probably the first to show that ultrasound could enhance fibrinolysis in vitro, likely by improving the transport of enzymes and/or plasminogen into clots.

Since then, numerous studies have been published, including clinical investigations.

Now, in the May 28 2026 issue of the NEJM, a clinical trial has been reported that may prove particularly significant:

‘In this trial, ultrasound-facilitated, catheter directed fibrinolysis plus anticoagulation led to a lower risk of the composite of pulmonary embolism–related death, cardiopulmonary decompensation or collapse, or symptomatic recurrence of pulmonary embolism within 7 days than anticoagulation alone in patients with acute, intermediate-risk pulmonary embolism. No apparent differences between the two treatment groups with regard to major bleeding complications were observed’.”

Title: Ultrasound-Facilitated, Catheter-Directed Fibrinolysis for Acute Pulmonary Embolism

Authors: Kenneth Rosenfield, Frederikus A. Klok, Gregory Piazza, Andrew S.P. Sharp, Fionnuala Ní Áinle, Michael R. Jaff, Stefano Barco, Samuel Z. Goldhaber, Nils Kucher, Irene M. Lang, Irene Schmidtmann, Keith M. Sterling, Aleksander Araszkiewicz, Vishal Arora, Rafael Cires-Drouet, John Coghlan, Lukas Hobohm, Wulf D. Ito, Kurt Jacobson, Christoph Kaiser, Grzegorz Kopec, Kristin Marx, Samuel McElwee, Nicolas Meneveau, Peter Monteleone, Jose M. Montero-Cabezas, Christoph B. Olivier, John Park, Marek Roik, Rahul Sakhuja, Andi Tego, Markus Theurl, Gautam Visveswaran, Jan Albert Vos, Michael N. Young, Federico M. Asch, Stavros V. Konstantinides

Pall T. Onundarson: The 3-Decade Journey of Ultrasound-Enhanced Fibrinolysis in PE

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Acute Pulmonary Embolism Aleksander Araszkiewicz Andi Tego Andrew S.P. Sharp Christoph B. Olivier Christoph Kaiser clot Federico M. Asch fibrinolysis Fionnuala Ní Áinle Frederikus A Klok Gautam Visveswaran Gregory Piazza Grzegorz Kopec Health Hematology Hemostasis Hemostasis News Hemostasis Today Irene M. Lang Irene Schmidtmann Jan Albert Vos John Coghlan John Park Jose M. Montero-Cabezas Keith M. Sterling Kenneth Rosenfield Kristin Marx Kurt Jacobson Lukas Hobohm Marek Roik Markus Theurl Medicine Michael N. Young Michael R. Jaff NEJM Nicolas Meneveau Nils Kucher PE Peter Monteleone Rafael Cires-Drouet Rahul Sakhuja Samuel McElwee Samuel Z. Goldhaber Stavros V. Konstantinides Stefano Barco Strong Memorial Hospital thrombosis University of Rochester Medical Center Vishal Arora Wulf D. Ito
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