Thrombectomy for intermediate-high risk PE improved 90-day walking distance

Design

Randomised controlled trial, 22 sites

Population

100 patients with acute intermediate-high risk pulmonary embolism

Primary outcome

RV/LV ratio change at 48 h; 90-day functional outcomes reported here

Effect

6-min walk 479 vs 368 m; NYHA class I 97% vs 76%

STORM-PE randomised 100 patients with acute intermediate-high risk pulmonary embolism at 22 international sites to computer-assisted vacuum thrombectomy plus anticoagulation or anticoagulation alone. Its primary end point was the change in right-to-left ventricular ratio at 48 hours; this report covers the 90-day functional and safety outcomes.

At 90 days, six-minute walk distance was longer after thrombectomy (mean 479 m against 368 m, P=0.003), and more patients were in NYHA class I (97% against 76%). Dyspnoea and quality-of-life scores were similar, and there was no difference in death, PE-related death or recurrence.

The trial is small, open to bias in functional testing, and only about two-thirds of each arm completed the walk test, so missing data could distort the result. It is an encouraging signal for patient-centred outcomes, but not yet a reason to move routine intermediate-high risk patients to thrombectomy outside guideline-based escalation.

• Continue to manage intermediate-high risk PE with anticoagulation and close monitoring as the default.
• Discuss catheter-based reperfusion with a PE response team for patients who deteriorate or are borderline.
• Measure functional recovery after PE, as up to half of survivors report persisting limitation.
• Interpret this trial's functional result cautiously, given missing walk-test data.

Why it matters

Reperfusion trials in PE have rarely measured how patients actually function afterwards.

Don't overread it

These are secondary outcomes from a 100-patient trial, with incomplete walk-test data.

The statistics, in plain English

A 110-metre difference in walk distance is clinically meaningful if real. But with a third of patients missing the test, those who completed it may not represent everyone randomised.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.