tPA by Endovascular Administration for the Treatment of Submassive PE Using CDT for the Reduction of Thrombus Burden

Inclusion Criteria: 1. Willing and able to provide informed consent; 2. Age 18 to ≤ 75 years of age; 3. PE symptom duration ≤ 14 days. 4. Filling defect in at least one main or lobar pulmonary artery as determined by contrast enhanced chest CT (CTA); 5. RV/LV diameter ratio ≥ 0.9 by CTA as determined by the investigative site; 6. Willing and able to comply with all study procedures and follow-up. Exclusion Criteria: 1. CVA or TIA within one (1) year; 2. Head trauma, active intracranial, or intraspinal disease ≤ one (1) year prior to inclusion in the study; 3. Active bleeding from a major organ within one (1) month prior to inclusion in the study; 4. Intracranial condition(s) that may increase the risk of bleeding (e.g., neoplasms, arteriovenous malformations, or aneurysms); 5. Patients with bleeding diatheses; 6. Hematocrit \< 30%; 7. Platelets \< 100,000/μL; 8. INR \> 1.5 if currently on warfarin (Coumadin®); 9. aPTT \> 50 seconds in the absence of anticoagulants; 10. Major surgery ≤ 14 days prior to inclusion in the study; 11. Serum creatinine \> 2.0mg/dL; 12. Clinician deems high-risk for catastrophic bleeding; 13. History of heparin-induced thrombocytopenia (HIT Syndrome); 14. Pregnancy; 15. SBP \< 90 mmHg \> 15 minutes within two (2) hours prior to BEC procedure and is not resolved with IV fluids; 16. Any vasopressor support; 17. Cardiac arrest (including pulseless electrical activity and asystole) requiring active cardiopulmonary resuscitation (CPR) during this hospitalization at treating institution and/or referring institution; 18. Evidence of irreversible neurological compromise; 19. Life expectancy \< one (1) year; 20. Use of thrombolytics or glycoprotein IIb/IIIa inhibitor within 3 days prior to inclusion in the study; 21. Use of non-vitamin K oral anti-coagulants (NOACs), such as rivaroxaban (Xarelto®), apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®) within 48 hours prior to inclusion in the study; 22. Profound bradycardia requiring a temporary pacemaker and/or inotropic support; 23. Previous enrollment in this study; 24. Morbidly obese patient who by the judgement of the investigator is high risk for bleeding; 25. BMI \> 45kg/m2; 26. Absolute contraindication to anticoagulation; 27. Uncontrolled hypertension defined as SBP \> 175mmHg and / or DBP \> 110mmHg with pharmacotherapy within two (2) hours prior to inclusion in the study; 28. Currently participating in another study; 29. Any arterial line placement; 30. Current positive COVID diagnosis, or ≤ 8 weeks negative of COVID, or \> 8 weeks from positive COVID test and with current symptoms, or current active viral pneumonia on chest CT scan; 31. In the opinion of the investigator, the subject is not a suitable candidate for the study.