Meta-Analysis Examines Mortality With Mechanical Thrombectomy Versus Anticoagulation in Intermediate-Risk PE

November 4, 2026—The Society for Cardiovascular Angiography and Interventions (SCAI) announced findings from a systematic review and meta-analysis showing that mechanical thrombectomy was associated with lower short- and long-term mortality compared with anticoagulation alone in patients with intermediate-risk pulmonary embolism (PE). The findings were presented at TCT 2026 by Mahmoud Ismayl, MD, and simultaneously published in JSCAI.

The study, titled “Mechanical Thrombectomy Versus Anticoagulation Alone for Intermediate-Risk Pulmonary Embolism: A Systematic Review and Meta-Analysis,” included 12 studies involving 4,268 patients, of whom 1,878 (44%) underwent mechanical thrombectomy.

In the primary analysis, mechanical thrombectomy was associated with lower mortality at 30 days, 1 year, and 2 years compared with anticoagulation alone. Mechanical thrombectomy was also associated with a lower risk of chronic thromboembolic pulmonary hypertension (CTEPH).

The press release from SCAI noted that a sensitivity analysis restricted to studies exclusively enrolling patients with intermediate-risk PE found similar 30-day mortality between treatment groups. The lower risk of CTEPH associated with mechanical thrombectomy remained statistically significant in this analysis.

The investigators were unable to pool 1- and 2-year mortality outcomes in the sensitivity analysis because each was reported by only one study.

“This analysis found encouraging associations between mechanical thrombectomy and lower short- and long-term mortality in patients with intermediate-risk PE,” stated study author Mahmoud Ismayl, MD, interventional cardiology fellow and Assistant Professor at Mayo Clinic in Rochester, Minnesota, in the SCAI press release. “However, most of the available evidence is observational, and the more focused sensitivity analysis did not show a significant difference in 30-day mortality. Larger randomized trials are needed to confirm these findings and determine which patients are most likely to benefit.”