Clinical Research Directory

Inclusion Criteria: * Age 18-80 years. * Acute pulmonary embolism confirmed by CTPA, with symptom onset to diagnosis ≤14 days. * Imaging evidence of right ventricular dysfunction (CTPA RV/LV diameter ratio ≥1.0, or echocardiographic right ventricular dilation/hypokinesia) and elevated cardiac injury biomarkers (troponin I or T above the upper limit of normal). * Presence of a contraindication to systemic thrombolysis, or failure of systemic thrombolysis, or clinical deterioration during anticoagulation. * Thrombus visible in the main pulmonary artery and/or lobar arteries on CTPA. * Provision of signed informed consent. Exclusion Criteria: * Cardiac arrest at enrollment; systolic blood pressure \<80 mmHg for \>15 minutes unresponsive to fluid resuscitation and vasopressors. * Active bleeding; known coagulopathy (INR \>2.0 or platelet count \<50×10⁹/L); intracranial hemorrhage within 90 days, or intracranial tumor/vascular malformation; major surgery, major trauma, or stroke within 30 days. * Known heparin allergy or a history of heparin-induced thrombocytopenia. * Prior systemic thrombolytic therapy. * Known chronic thromboembolic pulmonary hypertension (CTEPH); severe left ventricular dysfunction (LVEF \<30%); severe valvular heart disease; end-stage renal disease (eGFR \<30 mL/min/1.73 m²); pregnancy or lactation. * Intracardiac or intrapulmonary mass on CTPA; severe stenosis or occlusion of the inferior vena cava or iliofemoral vein. * CTPA image quality inadequate for independent core laboratory interpretation. * Current participation in another clinical study that could interfere with endpoint assessment.