A number of topics relating to pulmonary embolism (PE) management—including lytic therapy versus thrombectomy, risk stratification and device selection—will feature this afternoon during an educational session. Taking place from 3:15–4.45 p.m. on the Second Floor (Room 217–219) at the 2025 Vascular Annual Meeting (VAM) in New Orleans, the session will also see experts discuss current evidence and the role of vascular surgeons within the “evolving landscape” of PE management.
The session is set to be moderated by Natalie Sridharan, MD, MS, assistant professor of surgery at the University of Pittsburgh Medical Center (UPMC) in Pittsburgh, Pennsylvania, and Linda Le, MD, assistant professor of clinical cardiovascular surgery at Houston Methodist Hospital in Houston, Texas.
“PE remains a highly lethal problem, with mortality rates relatively unchanged in recent times,” Sridharan told VS@VAM. “Catheter-directed interventions for PE have grown in popularity with a rapidly proliferating number of devices designed for thrombus removal. The evidence basis for intervention is also growing, but has somewhat lagged behind device development.”
Efthymios Avgerinos, MD, associate professor of vascular surgery at the University of Athens in Athens, Greece, will kick off the session by outlining existing evidence on PE intervention—posing the question: is there a mortality benefit, and does it matter?
Risk stratification in acute PE will feature next, with Patrick Muck, MD, chief of the Section of Vascular Surgery at Good Samaritan Hospital in Cincinnati, Ohio, taking to the podium to discuss methods for determining which patients will truly benefit from interventional treatments as well as ensuring these patients are treated in a timely fashion.
Following this, a debate over whether catheter-directed lysis versus percutaneous thrombectomy can be a “data-driven decision” will be contested by Fanny Alie-Cusson, MD, assistant professor of vascular surgery at Atrium Health in Charlotte, North Carolina, and Zachary AbuRahma, DO, assistant professor of vascular surgery at Charleston Area Medical Center in Charleston, West Virginia.
These discussions will be followed up by a talk from Steven Abramowitz, MD, chair of the Department of Vascular Surgery at MedStar Washington Hospital Center in Washington, D.C., who will present on device selection in PE intervention and ask: is bigger always better when it comes to thrombus removal?
Sridharan will subsequently take to the podium herself for the session’s penultimate presentation, providing insights on “how to deal with PE in transit,” including advice on when and how to intervene safely.
The session is set to conclude with a presentation from Dennis Gable, MD, chief of vascular and endovascular surgery at the Baylor Scott and White Heart Hospital in Plano, Texas, who will shine a spotlight on the role for vascular surgeons as a part of PE response teams—drilling down into whether they should be considered “leaders, or spectators.”
“Vascular surgeons need to be leaders in the management and treatment for PE, and all thromboembolic disorders,” Gable told VS@VAM.
“Vascular surgeons are the experts of the vascular system—both arterial and venous. However, vascular surgeons remain underrepresented in the management of PE and leadership of PE response teams,” Sridharan added. “Remaining not only involved but at the forefront of PE management is important for the well-rounded vascular program.”
