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    Percutaneous thrombectomy for massive pulmonary embolism

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    1 Draft recommendations

    1.1 Percutaneous thrombectomy for massive pulmonary embolism (PE) should be used only in research. Find out what only in research means on the NICE interventional procedures guidance page.

    1.2 Further research should be in the form of randomised controlled trials or registries.

    1.3 Further research should report:

    • patient selection

    • size and position of the clot

    • degree of right ventricular dysfunction

    • details of the procedure, including the device used

    • short-term and long-term outcomes, including patient-reported outcomes.

    Why the committee made these recommendations

    There is enough evidence that the procedure reduces clot burden but not enough evidence of improvement in short- and long-term outcomes. There is also not enough good quality evidence on safety. There is no data from randomised controlled trials and very little evidence of long-term follow up, particularly patient-reported outcomes. Although this procedure is being assessed for massive PE, most of the data is for sub-massive PE.