Ep. 508 Advancements in Pulmonary Embolus Intervention Techniques: PEERLESS Trial Insights with Dr. Ripal Gandhi and Dr. Zarina Sharalaya

BackTable Vascular & Interventional

Interventional treatment for pulmonary embolism (PE) has significantly evolved in recent years, largely due to advancements in techniques, knowledge, and device technology. Dr. Zarina Sharalaya (interventional and structural cardiologist) and Dr. Ripal Gandhi (interventional radiologist) join host Dr. Chris Beck to discuss the evolving landscape of PE treatment, comparing large-bore mechanical thrombectomy with catheter-directed thrombolysis and exploring outcomes from the PEERLESS randomized control trial.

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This podcast is supported by:

Inari Medical

https://cwa.inarimedical.com/inari-learn

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SYNPOSIS

Dr. Sharalaya and Dr. Gandhi begin by covering risk stratification and treatment algorithms for their patients with PE. The doctors then go onto discuss the procedure in detail, and best practices and techniques for mechanical thrombectomy. The conversation also focuses on the PEERLESS trial, highlighting how the study showed significant benefits of mechanical thrombectomy, including faster symptom improvement, decreased ICU stay, and reduced readmission rates. Dr. Sharalaya and Dr. Gandhi conclude the episode with a series of case presentations.

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TIMESTAMPS

00:00 - Introduction

08:01 - Pulmonary Embolism Risk Stratification and Treatment Algorithms

14:49 - Procedure Overview

24:25 - Best Practices and Techniques in Thrombectomy

34:31 - Peerless Study Overview and Findings

46:50 - Gender Differences in PE Treatment

47:49 - Future of PE Treatment and Advice

51:55 - Case Presentations and Clinical Insights

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RESOURCES

2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS):

https://pubmed.ncbi.nlm.nih.gov/31504429/

PEERLESS II: A Randomized Controlled Trial of Large-Bore Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism:

https://www.jscai.org/article/S2772-9303(24)01053-6/fulltext

Large-bore Mechanical Thrombectomy Versus Catheter-directed Thrombolysis in the Management of Intermediate-risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial:

https://pubmed.ncbi.nlm.nih.gov/39470698/