Clinical Research Directory

Inclusion Criteria: 1. Age 18 years or older, able to consent 2. Submassive PE evidenced by CT showing saddle pulmonary embolism, central right and/or left main pulmonary artery emboli. 3. Submassive PE confirmed by right ventricular dimension to left ventricular dimension ratio ≥ 1 in apical 4-chamber view echo/CT scan. 4. Signs of RV dysfunction by echocardiogram, or elevated troponin I \>0.04, or pro-BNP \> 400 on serial measurements. 5. PE symptom duration less than or equal to 14 days - Exclusion Criteria: 1. Age \<18 to age \>90 years; 2. PE symptom duration \>14 days; 3. Administration of thrombolytic drugs in the last 4 days 4. Contraindications to thrombolytic therapy: 1. Active bleeding disorder or coagulation disorder; 2. Platelet count \<100 000/mm3 3. Hematocrit \< 30% 4. INR\> 3 5. Previous history of vitamin K antagonists with international normalized ratio \>2.5 on admission 6. History of intracranial or intraspinal surgery or trauma or intracranial/intraspinal bleeding 7. Intracranial neoplasm 8. Arteriovenous malformation, or aneurysm 9. Gastrointestinal bleeding \<3 months 10. Internal eye surgery or hemorrhagic retinopathy less than three-month duration 11. Major surgery, cataract surgery, obstetric delivery, cardiopulmonary resuscitation, or invasive procedure less than10 days duration 12. Allergy, hypersensitivity, or thrombocytopenia caused heparin or tPA 5. Severe contrast allergy to iodinated contrast 6. Large (\>10 mm) right atrial or right ventricular thrombus 7. Systolic blood pressure \<90 mm Hg 8. Severe hypertension on repeat measurement (systolic \>180 mm Hg or diastolic \>105 mm Hg) 9. Pregnancy 10. In any other investigational drug or device study 11. Inability to follow instructions or comply with treatment \-