Men and women fare similarly after catheter clot removal for lung embolism

Women and men treated with a catheter-based clot removal procedure for intermediate-risk pulmonary embolism showed broadly similar short-term results, according to new research presented at TCT 2026 in San Diego and simultaneously published in JSCAI. The findings come from a secondary analysis of the SYMPHONY-PE IDE trial, a prospective study of the Symphony Thrombectomy System, a device designed to aspirate blood clots from the pulmonary arteries. Although women entered treatment with more signs of physiological strain, their clot reduction, hospital stays and discharge outcomes closely matched those of men.

The analysis covered 109 patients enrolled at 17 centers across the United States, a cohort that included 43 women and 66 men.

The sex difference that mattered most appeared before any device was activated. Women more frequently showed elevations in blood markers of heart strain, laboratory signals that the right side of the heart is being stressed by the clot’s resistance to blood flow. They also carried higher shock-risk scores, composite measures that clinicians use to estimate how likely a patient is to deteriorate toward circulatory collapse. Taken together, these baseline findings suggested that the women in the trial arrived at the catheterization laboratory in a riskier physiological state than the men.

Once treatment was complete, however, that pre-procedure gap largely disappeared in the short-term measurements. Clot reduction, the degree to which the thrombus burden was lowered by the aspiration device, was similar between the sexes. Both groups recorded a median hospital stay of three days after the procedure, and in each group approximately 98 percent of patients were discharged home rather than to a rehabilitation facility or ongoing inpatient care.

Safety outcomes through 30 days were also notable. No deaths occurred in either group, and no device-related serious adverse events were reported. Major bleeding, one of the most closely watched complications of interventional clot management, occurred in two women and in no men among patients with available follow-up. The investigators emphasized that the numbers were small, so a difference of two bleeding events in a cohort of this size cannot support firm conclusions about whether the sexes truly differ in bleeding risk after this procedure.

“Women in this study showed signs of higher risk before treatment, yet most short-term results following clot removal were similar to those of men. These findings highlight the need to better understand how pulmonary embolism affects women and men and how those differences may inform treatment,” said Arman Qamar, MD, MPH, FSCAI, director of the Center for Cardiovascular Personalized Medicine and co-director of the Pulmonary Embolism Response Team at Endeavor Health Cardiovascular Institute in Glenview, Illinois.

The authors were careful to frame the analysis as hypothesis-generating rather than definitive. The study was too small to establish that outcomes are equivalent between women and men, and it could not draw firm conclusions about the magnitude or clinical meaning of any sex-based differences.

Several further limitations shape how the results should be read. The trial evaluated a single device, the Symphony Thrombectomy System, and the findings may not apply to other thrombectomy platforms with different mechanisms or designs. In addition, the trial did not compare the device against anticoagulation alone, the standard blood-thinning medication strategy, meaning the study cannot speak to whether mechanical clot removal outperforms medication-based care for either sex.

The work was presented at TCT 2026, the annual scientific meeting focused on interventional cardiovascular medicine, and the corresponding publication carries the DOI 10.1016/j.jscai.2026.105751 in JSCAI, the journal of the Society for Cardiovascular Angiography and Interventions.

Subject of Research: Sex differences in risk profile and short-term outcomes after aspiration thrombectomy for intermediate-risk pulmonary embolism

Article Title: Women and men show similar short-term outcomes after aspiration thrombectomy for pulmonary embolism

Article References: Women and men show similar short-term outcomes after aspiration thrombectomy for pulmonary embolism. Original publication (Bibliographic details unavailable.)

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Keywords: pulmonary embolism, aspiration thrombectomy, SYMPHONY-PE IDE trial, sex differences, interventional cardiology, TCT 2026, JSCAI, heart strain markers, major bleeding, hospital length of stay, device safety, SCAI