A pulmonary embolism (PE) occurs when a blood clot — usually from the deep veins of the legs — travels to and blocks the arteries in the lungs. It ranges from a small clot with mild symptoms to a massive, life-threatening obstruction that causes the right heart to fail acutely.
What's actually going on in research
Catheter-directed thrombolysis — dissolving clots with clot-busting drugs delivered directly to the pulmonary arteries — is being compared to anticoagulation alone for intermediate-risk PE in large head-to-head trials. Direct oral anticoagulants are now standard for acute PE treatment and are being tested in special populations including cancer patients, pregnant women, and those with antiphospholipid syndrome. Factor XI inhibitors represent a new anticoagulation approach that may prevent clots with substantially less bleeding than current drugs.
Catheter-directed intervention
Delivering thrombolytic drugs or using suction catheters directly in the pulmonary artery is being compared with anticoagulation alone for intermediate-high risk PE in large clinical trials.
Extended anticoagulation
Direct oral anticoagulants are being tested for optimal duration in unprovoked PE — with trials asking whether indefinite therapy or stopping after 3–6 months is safer over the long run.
Factor XI inhibitors
New drugs blocking Factor XI aim to prevent clot formation with significantly lower bleeding risk than current anticoagulants, potentially changing PE treatment for high-bleeding-risk patients.
What to know before you search
Eligibility depends on PE severity (submassive vs. massive), right heart strain on imaging, bleeding risk, and prior anticoagulation history.
What types of trials are currently open
- Treatment trials — Comparing anticoagulation alone versus catheter-directed or systemic thrombolysis for intermediate and high-risk PE.
- Anticoagulant comparison trials — Testing direct oral anticoagulants versus warfarin in special populations including cancer and antiphospholipid syndrome.
- Duration trials — Comparing short versus extended anticoagulation for unprovoked PE to balance recurrence and bleeding risk.
- Novel anticoagulant trials — Evaluating Factor XI inhibitors and other new anticoagulants for PE prevention and treatment.
- Long-term outcomes studies — Tracking development of chronic thromboembolic pulmonary hypertension after acute PE.
Recently added Pulmonary Embolism trials
Pulmonary Embolism and Right-to-Left Shunts
Every fetus has a small hole in their heart, called a foramen ovale when they are developing in the womb. For most people this hole closes shortly after birth, but it doesn't close completely in 1 out of every 4 people. This is called a "patent" foramen ovale, or PFO. In people with a PFO it is possible for a blood clot in a vein to enter the heart, pass through the opening, and then go into an artery - this is referred to as a paradoxical embolism which passes through a "Right-to-Left Shunt," or RLS. If this occurs, the blood clot can cause a stroke. The most common RLS (more than 90%) is a PFO. Much rarer causes include other types of holes in the heart (like an atrial septal defect, or ASD), or a vascular communication in the lungs (like a pulmonary arteriovenous malformation, or AVM). We are investigating whether people with a PE are at higher risk of stroke if they happen to have an RLS compared to PE patients who don't have an RLS. This study will simply observe and compare the differences in stroke-related outcomes between those 2 groups. Participation in the study last roughly 90-days and includes the following activities: * The study team will review your medical records to collect general information such as your age, sex, race/ethnicity, height, weight, medications, medical history, and other medical information * Magnetic Resonance Imaging (MRI) of your brain will be done as soon as possible following your enrollment in the study. For more information on MRI scans, please see the "MRI scan" section below. * A Transcranial Doppler (TCD) with bubble study will be performed to determine if an opening is present in your heart or lungs. TCD is performed using ultrasound. A contrast called agitated saline will be injected into your vein for this test. * You will be asked to return for a follow-up visit 90 days after your pulmonary embolism. At this visit, the following will occur: 1. A second MRI of your brain will be performed. 2. You will complete a questionnaire to evaluate whether you may have had a stroke since being discharged from the hospital 3. You will meet with a member of the study team who will collect information about your health status.
Repeated Examinations for Typing Pulmonary Embolism
PURPOSE The two related purposes of the RE-TyPE study are: 1. To improve understanding of the early clinical course of intermediate-high risk pulmonary embolism and its association with outcome and 2. To establish a platform for longitudinal follow-up for all pulmonary embolism at Sahlgrenska University Hospital HYPOTHESES 1. The dynamic pattern of change, evaluated thorough repeated measures of biomarkers, electrocardiography and echocardiography during the first 48 hours after pulmonary embolism, better predicts outcome than static measurements currently used to predict outcome 2. Establishment of a platform for longitudinal follow-up will improve quality of care and outcome for patients with pulmonary embolism at Sahlgrenska University Hospital
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