{
  "abstract": "Purpose\n\nLarge-bore mechanical thrombectomy is an emerging treatment for intermediate-high-risk pulmonary embolism. We report outcomes from an Australian cohort.Material and methods\n\nA retrospective analysis compared patients with intermediate-high-risk pulmonary embolism, defined according to the 2019 European Society of Cardiology guidelines, who were managed before large-bore mechanical thrombectomy implementation (May 2023-April 2024) with those treated with large-bore mechanical thrombectomy (May 2024-October 2025) at a teaching hospital within a multidisciplinary pulmonary embolism response team framework. The primary endpoint was procedural feasibility and safety. Secondary endpoints included hemodynamic changes, intensive care unit utilization and 30-day mortality.Results\n\nSixty-seven patients were included: 24 treated with large-bore mechanical thrombectomy (median age 66.5, interquartile range 51.8-73.0 years; 58.3% male) and 43 treated with anticoagulation and/or thrombolysis (median age 76.0, interquartile range 65.5-82.5 years; 34.9% male). Technical success was 100%. Mean pulmonary arterial pressure decreased from 28.5 ± 8.7 to 21.2 ± 5.6 mmHg (p < 0.001). Heart rate and respiratory rate improved at 24 hours (both p < 0.001), although adjusted analyses showed no significant between-group differences in hemodynamic changes. Intensive care unit length of stay was shorter in the large-bore mechanical thrombectomy group (20.1 ± 7.9 vs 32.2 ± 17.3 hours, p = 0.003), with multivariable analysis confirming an independent 43% reduction (exp(β) = 0.57, 95% confidence interval 0.42-0.79, p = 0.001). No major bleeding events or deaths within 30-days occurred in the large-bore mechanical thrombectomy group, compared with two major bleeding events (4.7%) and three mortalities (7.0%) in the non-large-bore mechanical thrombectomy group.Conclusions\n\nLarge-bore mechanical thrombectomy appears to be a safe and feasible treatment modality for intermediate-high-risk pulmonary embolism and was associated with reduced intensive care unit utilization compared with conventional therapies. These findings are hypothesis-generating and require validation in larger, prospective studies.",
  "abstract_shown": true,
  "affiliations": [
    "Interventional Radiology Service, Northern Imaging Victoria, Northern Health, Australia.",
    "Northern Clinical Diagnostics and Thrombovascular Research (NECTAR) Group, Northern Health, Australia.",
    "Department of Medicine - Northern Health, University of Melbourne, Australia.",
    "Department of Haematology, Northern Pathology Victoria, Northern Health, Australia.",
    "Australian Centre for Blood Diseases, Monash University Australia.",
    "School of Health and Biomedical Sciences, RMIT University, Australia.",
    "Intensive Care Unit, Northern Health, Australia."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Roy Kingsley Wong"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Goran Mitreski"
    },
    {
      "affs": [
        1,
        3,
        2,
        4,
        5
      ],
      "name": "Hui Yin Lim"
    },
    {
      "affs": [
        6
      ],
      "name": "David Crosbie"
    },
    {
      "affs": [
        6
      ],
      "name": "Rohit Paliwal"
    },
    {
      "affs": [
        0
      ],
      "name": "Philip Chan"
    },
    {
      "affs": [
        0
      ],
      "name": "Tamburayi Cephas Kamba"
    },
    {
      "affs": [
        0
      ],
      "name": "Jack Griffin"
    },
    {
      "affs": [
        1,
        3,
        2,
        4,
        5
      ],
      "name": "Prahlad Ho"
    },
    {
      "affs": [
        0,
        1,
        2,
        5
      ],
      "name": "Hong Kuan Kok"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ffn6hws8b54mg.bib",
  "cited_by": 0,
  "doi": "10.22575/interventionalradiology.2026-0006",
  "fulltext_url": "https://europepmc.org/articles/PMC13713251",
  "id": "ffn6hws8b54mg",
  "issns": [
    "2432-0935"
  ],
  "landing_url": "https://europepmc.org/article/MED/42952484",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7221760481",
  "pdf_url": "https://europepmc.org/articles/PMC13713251?pdf=render",
  "pmcid": "PMC13713251",
  "pmid": "42952484",
  "published": "2026-10-15",
  "publisher": "Japanese Society of Interventional Radiology (JSIR)",
  "ris": "https://research.draconitic.com/paper/ffn6hws8b54mg.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:34Z",
      "native_id": "MED:42952484",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42952484"
    },
    {
      "first_seen": "2026-10-31T12:23:50Z",
      "native_id": "PMC13713251",
      "source": "pmc",
      "url": "https://doi.org/10.22575/interventionalradiology.2026-0006"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2724|Venous Thromboembolism Diagnosis and Management",
      "subfield": "general"
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  ],
  "title": "Large-bore Mechanical Thrombectomy for Treatment of Intermediate-high Risk Pulmonary Embolism: A Single-center Australian Experience.",
  "title_text": "Large-bore Mechanical Thrombectomy for Treatment of Intermediate-high Risk Pulmonary Embolism: A Single-center Australian Experience.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T12:20:57Z",
  "url": "https://research.draconitic.com/paper/ffn6hws8b54mg",
  "venue": "Interventional radiology (Higashimatsuyama-shi (Japan)",
  "versions": []
}