Ultrasound-Assisted Catheter-Directed Thrombolysis in Pulmonary Embolism: A Case Series

Pulmonary embolism (PE) is a life-threatening condition associated with significant morbidity and mortality. While systemic thrombolysis is effective in high-risk cases, it carries a substantial risk of bleeding complications. Ultrasound-assisted catheter-directed thrombolysis (UCDT) has emerged as a promising alternative, enhancing clot resolution while minimizing hemorrhagic risks. This case series presents three patients with high-risk and intermediate-high-risk PE who underwent UCDT. All patients exhibited hemodynamic instability and right ventricular dysfunction. Following UCDT, significant clinical and echocardiographic improvements were observed, with no major bleeding complications. UCDT represents a targeted thrombolysis approach that optimizes clot dissolution while reducing systemic thrombolytic exposure. Current evidence supports UCDT as an effective and safer alternative for select PE patients, though further randomized studies are needed to refine patient selection and standardize treatment protocols. This case series highlights the clinical benefits of UCDT and reinforces its role as a viable treatment strategy.