BackTable Vascular & Interventional Ep. 508 Advancements in Pulmonary Embolus Intervention Techniques: PEERLESS Trial Insights with Dr. Ripal Gandhi and Dr. Zarina Sharalaya
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Jan 14, 2025 Dr. Ripal Gandhi, an interventional radiologist focused on pulmonary embolism, teams up with Dr. Zarina Sharalya, an interventional cardiologist, to discuss groundbreaking advancements in treating pulmonary embolism. They dive into the PEERLESS trial, showcasing how mechanical thrombectomy leads to faster recovery and fewer ICU days. The conversation also explores risk stratification, treatment algorithms, and the importance of optimizing catheter techniques. Personal anecdotes highlight the emotional challenges faced in patient care, emphasizing the human side of medical interventions.
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Thrombectomy Benefits
- Large-bore thrombectomy shows significant benefits for intermediate-risk PE.
- Patients experience faster symptom improvement, shorter ICU and hospital stays, and reduced readmissions.
PE Workup
- Obtain key labs (troponin, pro-BNP, lactate) for risk stratification in PE patients.
- Consider a stat echo for larger or saddle PEs to aid in procedure planning.
Treatment Algorithm
- Intervene on most intermediate-high-risk PE patients.
- For intermediate-low-risk patients, consider treatment if they decompensate during a walk test.