P38 Can district general hospitals deliver advanced pulmonary embolism care? A two-year real-world experience of catheter-directed therapy
Year: 2026
Type: conference-abstract
Abstract: Introduction and Objectives Acute pulmonary embolism (PE) is a major cause of cardiovascular morbidity and mortality. Catheter-directed therapy (CDT), including catheter-directed thrombolysis and mechanical thrombectomy, is increasingly used for high-risk and intermediate-high-risk PE. However, advanced PE interventions are usually delivered in tertiary centres, with limited real-world evidence from district general hospitals (DGHs). We aimed to assess the safety, feasibility and clinical outcomes of CDT delivered within a UK DGH. Methods We conducted a retrospective observational study of consecutive patients who underwent CDT for acute PE between August 2020 and November 2022 at a UK DGH. CDT was delivered through a multidisciplinary pulmonary embolism response team model involving interventional radiologists and respiratory physicians. Demographic, clinical, radiological, procedural and outcome data were extracted from electronic medical records. Outcomes included in-hospital mortality, 30-day mortality, bleeding complications, intensive care admission and length of hospital stay. Descriptive analysis was performed using IBM SPSS Statistics. Results A total of 19 patients underwent CDT. Mean age was 57.2 years (SD 18.8), and 57.9% were male. Severe PE, defined as high-risk or intermediate-high-risk PE, was present in 17/19 patients (89.5%), and 3/19 patients (15.8%) presented following cardiac arrest. Mean RV:LV ratio on CT was 1.82 (SD 0.36), and right ventricular dysfunction was identified in 16/17 patients who underwent echocardiography (94.1%). Median lactate, time from diagnosis to CDT and length of hospital stay were 2.0 mmol/L (IQR 1.4–2.9), 23.5 hours (IQR 14.3–59.4) and 8 days (IQR 6.8–11.0), respectively. Overall, 7/19 patients (36.8%) required intensive care admission. In-hospital and 30-day mortality were both 10.5% (2/19). One death followed cardiac arrest due to massive PE, and one was secondary to sepsis. No deaths were directly related to CDT. No major or minor bleeding complications were observed. Further baseline characteristics, procedural details and clinical outcomes are summarised in table 1. Conclusions In a cohort largely composed of patients with severe PE, CDT showed a favourable balance of safety and effectiveness, with low mortality and no procedure related bleeding events. These results support the feasibility of delivering CDT as an advanced treatment option within appropriately resourced district general hospitals.
Source: Thorax
Institution: Basildon Hospital
Language: English
Subfield: Internal Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7225166754