Pedro Perez: Are We Entering a New Era in the Treatment of Intermediate-High-Risk PE?
Pedro Perez, Southeast Vascular Sales Manager at Argon Medical Devices, Inc., shared a post on LinkedIn:
“Are we entering a new era in the treatment of intermediate-high-risk pulmonary embolism?
For years, VTE care has been heavily focused on one question:
- How much clot can we remove?
I think the more important question now is becoming:
- Which patients actually benefit from having it removed – and how early should we intervene?
That distinction matters.
New randomized data in intermediate-high-risk pulmonary embolism are beginning to push the field beyond device performance and surrogate endpoints alone.
In the recently published PRAGUE-26 randomized trial, catheter-directed therapy plus anticoagulation reduced the 7-day composite of death, recurrent PE, or cardiorespiratory decompensation/collapse compared with anticoagulation alone.
That does not mean every intermediate-high-risk PE patient should go to the lab.
It means our conversation needs to evolve.
The future of VTE treatment will not be defined simply by who has the biggest catheter, the strongest aspiration, or the fastest procedure.
It will be defined by patient selection, timing, physiology, evidence, and the ability to recognize deterioration before it becomes collapse.
That creates a challenge for all of us in the VTE space.
For physicians, the challenge is determining when anticoagulation is enough – and when waiting carries its own risk.
For industry and vascular consultants, our responsibility should be bigger than simply putting technology in front of physicians.
We should understand the disease.
We should understand RV dysfunction, biomarkers, hemodynamics, clot burden, bleeding risk and the clinical evidence well enough to have meaningful conversations around the patient — not just the device.
Because ultimately, the next evolution in VTE care is not going to come from more thrombectomy.
It is going to come from better thrombectomy, in the right patient, at the right time.
Do we feel this is where the field is headed?”
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