Percutaneous aspiration thrombectomy (PAT) is a novel minimally invasive procedure used to treat patients with pulmonary embolisms (blood clots in the lungs), one of the leading causes of cardiovascular death. In this report, evidence with regard to the comparative effectiveness and safety of PAT in patients with high-risk PE and intermediate risk PE that have developed haemodynamic instability and who are contraindicated or have failed systemic thrombolytics is summarised.

This systematic review captures evidence consisting of four studies: One retrospective matched-control case series (n=52) comparing PAT to catheter-directed thrombolysis (CDT) and three prospective single-arm studies (n=1,023). The certainty of evidence was very low mainly due to high imprecision (in the matched-controlled study) and risk of bias within observational studies.

In the absence of robust comparative data, no definitive conclusions can be drawn regarding the comparative effectiveness of aspiration thrombectomy compared with other procedures (such as CDT). Re-evaluation is recommended in 2025, when results from ongoing studies will be available.