Abstract Introduction / Purpose Pulmonary embolism (PE) remains a major cause of cardiovascular mortality. In particular, intermediate–high-risk patients represent a distinct group requiring thorough initial assessment and continuous monitoring for potential escalation of therapy (thrombectomy, thrombolysis). The minimally invasive measurement of cardiac output using the Vigileo© device is a safe, cost-effective, and simple method for assessing disease severity. Material and Methods At our center, between April 2023 and April 2025, we included 45 patients, of whom 28 (44.4%) underwent thrombectomy and 33 (55.6%) did not. The mean age was 63.6±15.8 years in the thrombectomy group and 66.5±17.7 years in the non-thrombectomy group, with women comprising 60% of each cohort. Comorbidities and PE risk factors such as hypertension, dyslipidemia, chronic kidney disease, malignancy, and recent surgery were similarly distributed between groups, with no statistically significant differences observed (all p0.05). Results At presentation, the thrombectomy group showed more pronounced right ventricular dysfunction, with an RV/LV ratio of 1.17±0.12 compared to 0.99±0.17 in the conservatively managed group (p=0.0007). Hemodynamic and respiratory parameters on admission were as follows: SBP 122.1±24.6 mmHg vs. 123.1±25.4 mmHg, DBP 77.0±14.5 mmHg vs. 77.9±12.4 mmHg, HR 114.3±16.6 bpm vs. 98.4±23.2 bpm, respiratory rate 26.0±3.0 bpm vs. 32.8±21.4 bpm, SpO2 91.0±3.5% vs. 92.7±4.6%, and FiO2 26.2±9.2% vs. 25.5±18.0% (thrombectomy vs. conservative management, respectively). Baseline cardiac index (CI) was lower in the thrombectomy group (2.52±0.62) compared to the control group (2.90±0.40, p=0.029). Moreover, improvement in CI over 48 hours (ΔCI) was significantly greater in the thrombectomy group (1.37±0.57 vs. 0.20±0.29, p0.001). Conclusion In our intermediate–high-risk acute PE patients, minimally invasive cardiac output measurement proved valuable both for risk stratification and for post-intervention monitoring.For image description, please refer to the figure legend and surrounding text.
Kachrimanidis et al. (Sun,) studied this question.