RT Journal Article SR Electronic T1 Safety and efficacy of catheter directed thrombolysis (CDT) in elderly with pulmonary embolism (PE) JF BMJ Open Respiratory Research JO BMJ Open Resp Res FD British Thoracic Society SP e000894 DO 10.1136/bmjresp-2021-000894 VO 8 IS 1 A1 Eneida Harrison A1 Jin Sun Kim A1 Vladimir Lakhter A1 Ka U Lio A1 Rami Alashram A1 Huaqing Zhao A1 Rohit Gupta A1 Maulin Patel A1 James Harrison A1 Joseph Panaro A1 Kerry Mohrien A1 Riyaz Bashir A1 Gary Cohen A1 Gerard Criner A1 Parth Rali YR 2021 UL http://bmjopenrespres.bmj.com/content/8/1/e000894.abstract AB Introduction Acute pulmonary embolism (PE) remains a common cause for morbidity and mortality in patients over 65 years. Given the increased risk of bleeding in the elderly population with the use of systemic thrombolysis, catheter-directed therapy (CDT) is being increasingly used for the treatment of submassive PE. Nevertheless, the safety of CDT in the elderly population is not well studied. We, therefore, aimed to evaluate the safety of CDT in our elderly patients.Methods We conducted a retrospective observational study of consecutive patients aged >65 years with a diagnosis of PE from our Pulmonary Embolism Response Team database. We compared the treatment outcomes of CDT versus anticoagulation (AC) in elderly. Propensity score matching was used to construct two matched cohorts for final outcomes analysis.Results Of 346 patients with acute PE, 138 were >65 years, and of these, 18 were treated with CDT. Unmatched comparison between CDT and AC cohorts demonstrated similar in-hospital mortality (11.1% vs 5.6%, p=0.37) and length of stay (LOS) (3.81 vs 5.02 days, p=0.5395), respectively. The results from the propensity-matched cohort mirrored results of the unmatched cohort with no significant difference between CDT and AC in-hospital mortality (11.8% vs 5.9%, p=0.545) or median LOS (3.76 vs 4.21 days, p=0.77), respectively.Conclusion In this observational study using propensity score-matched analysis, we found that patients >65 years who were treated with CDT for management of acute PE had similar mortality and LOS compared with those treated with AC. Further studies are required to confirm these findings.