Abstract 18461: Catheter Directed Thrombolysis versus Systemic Thrombolysis for the Treatment of Pulmonary Embolism

Introduction: Catheter-directed thrombolysis (CDT) and systemic thrombolysis (ST) are used to treat intermediate/high-risk pulmonary embolism (PE) in the absence of comparative safety and effectiveness data. We hypothesized that there would be no difference in clinical outcomes between CDT and ST when used for PE treatment. Methods: From OptumInsight’s private-payer insurance claims database, we identified 100,744 patients hospitalized with PE between 2004 and 2014. We extracted demographic characteristics, high risk PE features, components of the Elixhauser Comorbidity Index, and outcomes including intracranial hemorrhage (ICH), all-cause bleeding, and mortality among all patients receiving CDT and ST. We used propensity score methods to compare outcomes between matched cohorts adjusted for observed confounders. Results: Of 100,744 admissions for PE, 1,915 patients (1.9%) received either CDT (n=632) or ST (n=1283). The mean age in the CDT group was 57.3 years (± 16.3 years) and 57.5 years (± 16.6 years) ...