More tools. New evidence. Tough decisions. With the 2026 AHA/ACC pulmonary embolism (PE) guidelines as a backdrop, when is anticoagulation enough, and when is it time to reach for advanced therapy?

Behnood Bikdeli, Jane Leopold, Lisa Moores, and Suresh Vedantham return to take on the treatment questions that follow risk assessment. From fibrinolysis and mechanical thrombectomy to extracorporeal membrane oxygenation (ECMO), the panel weighs what the trials tell us, where uncertainty remains, and what matters at the bedside. Two patient cases put bleeding risk, clot anatomy, clinical trajectory, resources, and patient preferences into the mix.

Episode chapters

00:00 Welcome and the Advanced PE Therapy Toolkit
03:06 Fibrinolysis and Thrombectomy: What the Trials Show
11:25 ECMO and Immediate Priorities in High-Risk PE
16:55 Choosing an Intervention: Bleeding Risk, Anatomy, and Resources
20:09 Case Discussions: Anticoagulation Alone or Advanced Therapy?
27:31 Practical Takeaways

Thank you to our sponsor, Penumbra, for their generous support of this podcast episode. All content was independently developed by Vasculearn Network and the expert panel.

Missed the first conversation? Check out Part 1: PE Risk Stratification to explore the new framework and how to spot patients who may be heading toward trouble.