Ep. 669 Advancements in Pulmonary Embolism Algorithm & Management with Dr. David Dexter and Dr. Maya Serhal

How are new aspiration thrombectomy systems and real-time hemodynamic monitoring enabling safer, more effective pulmonary embolism treatment? On this episode of the BackTable Podcast, Dr. Ally Baheti welcomes Dr. Maya Serhal and Dr. David Dexter for a deep dive into modern pulmonary embolism (PE) management, with a focus on advances in large-bore aspiration thrombectomy. They discuss evolving PE triage algorithms, real-world procedural strategies, and the clinical impact of next-generation aspiration systems on safety, efficiency, and patient recovery.

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This podcast is supported by

Imperative Care
https://imperativecare.com/

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Timestamps

00:00- Introduction
02:03- PE Response Workflow
05:32- Symphony Device
07:07- Sizing and Blood Loss
10:00- Multi-Port Hemodynamics
14:45- Procedure Endpoints
17:01- IVUS Guided Strategy
20:02- ProHelix and Lollipopping
25:48- Case Studies
34:12- Closing Thoughts

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More about this episode

The conversation explores multidisciplinary PE response workflows, lab and imaging triggers for escalation, and technical considerations in catheter sizing, blood loss management, and real-time hemodynamic monitoring. Dr. Dexter reviews his use of intravascular ultrasound for precise clot localization, and Dr. Serhal shares practical tips for adjusting aspiration power to avoid complications. Together, they discuss procedural endpoints, mechanical assist devices for difficult clots, and present case examples demonstrating rapid improvement in hemodynamics and oxygenation. The episode emphasizes the importance of teamwork, patient selection, and ongoing innovation in optimizing PE care.

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Resources

American Society of Hematology 2020 Guidelines for Management of Venous Thromboembolism: Treatment of Deep Vein Thrombosis and Pulmonary Embolism
https://ashpublications.org/bloodadvances/article/4/19/4693/463998/American-Society-of-Hematology-2020-Guidelines-for

Prospective Multicenter IDE Study of the Next-Generation Precision Aspiration Thrombectomy System for Intermediate-Risk Pulmonary Embolism: The SYMPHONY-PE Trial
https://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.125.015815

Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE
https://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.126.016573
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