Catheter-directed therapies in patients with high-risk or intermediate-high-risk acute symptomatic pulmonary embolism with recent bleeding or high risk of bleeding. Analysis of implementing pulmonary embolism response team (PERT).

<bold>Introducction:</bold> Pulmonary embolism (PE) is a severe condition necessitating a multidisciplinary approach. Many institutions have adopted Pulmonary Embolism Response Teams (PERT) to optimize management. <bold>Objective:</bold> This study aims to analyze demographics and outcomes of patients with acute PE evaluated by a PERT, focusing on mortality rates. <bold>Materials and methods:</bold> Retrospective analysis of consecutive patients with symptomatic acute PE assessed by a multidisciplinary team. We requested clinical documentation for all hospitalized PE patients within the study period using the ICD-10 code (I26.99). We reviewed patient characteristics when evaluation was indicated, and the decisions made. We analyzed 7-days and in-hospital mortality. <bold>Results:</bold> From January 2021 to July 2023, 1,122 patients with PE were diagnosed in our center. Median age was 68 years with a slight male predominance. The primary admitting units were pulmonology and internal medicine. 8.9% were directly admitted to the ICU, and in-hospital mortality was 16.9%. 23 patients (2%) were evaluated by PERT, with 78% requiring catheter-directed therapy. In one-third of patients, the reason for catheter-directed therapy was recent severe bleeding, while in the rest, it was indicated due to a high risk of bleeding. 7-day mortality was 6.7%, with in-hospital mortality at 33%. <bold>Conclusion:</bold> The implementation of a multidisciplinary PE Code has allowed us to standardize clinical decisions in complex situations. Catheter-directed therapies were a safe treatment with low 7-day mortality