A67-03 Temporal Trends in Utilization of Pulmonary Embolism Response Teams and Interventional Therapies

Abstract Rationale Pulmonary Embolism Response Teams (PERTs) are multidisciplinary teams to improve the rapid assessment, risk stratification and standardization of pulmonary embolus (PE) management, including guiding the utilization of advanced interventional therapies, surgical thrombectomy, and extracorporeal membrane oxygenation (ECMO). We performed this study to understand temporal trends in PERT utilization and evolving interventional practices over time. Methods We performed a retrospective analysis of patients with acute PE referred to the University of Pittsburgh Medical Center PERT from 2015-2024. Demographics, laboratory, cardiac biomarkers, imaging, and clinical outcomes data were abstracted from the electronic medical record. Risk stratification of acute PE was performed using the 2019 European Society of Cardiology (ESC) guidelines. We used nonparametric testing to analyze temporal trends in (1) the proportion of all PE cases for which PERT was consulted, and (2) the proportion of PEs deemed intermediate risk, high risk, or with clot-in-transit for which advanced interventions were utilized. Advanced interventions included catheter directed thrombolysis (CDL), mechanical thrombectomy (MT), surgical embolectomy (SE), and systemic thrombolysis (ST). Results 3,531 unique cases of acute PE were included (58.6% low risk, 33.1% intermediate risk, 6.9% high risk, and 1.5% clot in transit). PE severity did not change over time. The proportion of PEs for which PERT was consulted over time increased from 38% in 2015 to 55% in 2024, (p = 0.05). CDL utilization peaked in 2015 and 2016 (26% and 26% of intermediate or high risk PEs) and decreased over time to 1% in 2024 (p = 0.006). MT increased from 0% in 2015 to 19% in 2024 (p = 0.006). SE and ST did not have a statistically significant change over time. Conclusions In a single hospital system multi-site registry of patients with acute PE, PERT utilization increased over time, while the overall severity of PE did not differ. The rise in PERT usage implies growing recognition of such multidisciplinary teams as an effective strategy for acute PE management. Further studies in this cohort will investigate reasons for the shift from catheter-directed thrombolysis and other advanced therapies to suction thrombectomy, and subsequent impact on clinical outcomes. This abstract is funded by: None