Thrombolysis Endovascular Treatment of Pulmonary Embolism

Inclusion Criteria: * CT evidence of proximal PE * Age ≥ 18 years * Pulmonary embolism symptom duration ≤14 days * Massive PE (syncope, systemic arterial hypotension, cardiogenic shock, or resuscitated cardiac arrest) OR Submassive PE (RV diameter-to-LV diameter ≥ 0.9 on contrast-enhanced chest CT) Exclusion Criteria: * Age \<18 years * PE symptom duration \>14 days * Stroke or transient ischemic attack (TIA), head trauma, or other active intracranial or intraspinal disease within one year * Recent (within one month) or active bleeding from a major organ * Pregnancy * Chronic pulmonary hypertension or severe chronic obstructive pulmonary disease * Administration of thrombolytic agents within the previous 3 days * Life expectancy \< 30 days * Any other condition that the investigator feels would place the patient at increased risk if the investigational therapy is initiated * Inability to follow protocol requirements