Mechanical Thrombectomy Versus Anticoagulation Alone in Intermediate-High Risk PE: Improved Functional 90-Day Outcomes in STORM-PE RCT.
Rachel P Rosovsky, Stavros V Konstantinides, Ido Weinberg et al.
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In 30 seconds
STORM-PE was a multicentre randomised trial comparing computer-assisted vacuum thrombectomy (CAVT) plus anticoagulation with anticoagulation alone in 100 patients with acute intermediate-high-risk pulmonary embolism. At 90 days, the CAVT group had a longer 6-minute walk distance than the anticoagulation group (478.7 ± 159.5 m vs 368.0 ± 127.8 m, P = 0.003), and more patients were NYHA functional class I (97.4% [37/38] vs 75.6% [34/45], P = 0.005). Dyspnea and quality-of-life scores were comparable, as were mortality and symptomatic PE recurrence.
Key findings
- At 90 days, 6-minute walk distance was 478.7 ± 159.5 m with CAVT versus 368.0 ± 127.8 m with anticoagulation alone (P = 0.003).
- NYHA functional class I at 90 days was reported in 97.4% [37/38] with CAVT and 75.6% [34/45] with anticoagulation alone (P = 0.005).
- Dyspnea and quality-of-life scores were comparable between groups; mortality and symptomatic PE recurrence also did not differ within 90 days.
Why it matters
Functional limitations can persist after pulmonary embolism, making recovery outcomes relevant alongside early physiological measures. This randomised comparison found better walking distance and functional class at 90 days with thrombectomy plus anticoagulation, while reported mortality and recurrence were similar. The findings add patient-centred outcome data to assessment of reperfusion strategies in intermediate-high-risk PE.
What to keep in mind
The trial enrolled 100 patients, and only 66.0% of CAVT and 64.2% of anticoagulation patients completed the 6-minute walk test at 90 days. Follow-up outcomes were reported through 90 days.