Role of catheter-based interventions in treating pulmonary embolism

Table 1 Simplified risk stratification for acute pulmonary embolism adapted from the 2019 European Society of Cardiology guidelines

Risk level	Key features	Prevalence in pulmonary embolism cases	Estimated 30-day mortality
HR	Indicators of severe circulatory compromise: Cardiac arrest; obstructive shock (systolic BP < 90 mmHg with organ damage); sustained low BP (< 90 mmHg or drop ≥ 40 mmHg for > 15 minutes) not due to arrhythmia/sepsis; high lactate levels (≥ 2 mmol/L)	5%–10%	30%–55%
Intermediate-high	Signs of RV strain and cardiac injury: RV/LV diameter ratio ≥ 1; TAPSE ≤ 16 mm; PESI class III–V or sPESI ≥ 1; elevated troponin or BNP	15%–20%	10%–15%
Intermediate-low	Presence of either: RV dysfunction (RV/LV ratio ≥ 1, TAPSE ≤ 16 mm, PESI III–V or sPESI ≥ 1); elevated cardiac biomarkers (troponin, BNP)	30%–40%	5%–15%
Low risk	Does not meet any of the above intermediate or HR criteria	30%–40%	< 3%

BNP: B-type Natriuretic Peptide; BP: Blood pressure; HR: High-risk; PESI: Pulmonary Embolism Severity Index; RV: Right ventricular; RV/LV: Right ventricular-to-left ventricle; TAPSE: Tricuspid Annular Plane Systolic Excursion; SPESI: Simplified Pulmonary Embolism Severity Index.