Mechanical Thrombectomy With Anticoagulation Versus Anticoagulation Alone for Acute Intermediate-High Risk Pulmonary Embolism
STORM-PE trial design and results
Design
Multicentre randomised controlled trial across 22 sites
Treatment
Catheter-assisted vacuum thrombectomy plus anticoagulation
Control
Anticoagulation alone
Population
100 patients with acute intermediate-high risk pulmonary embolism
Follow-up
48 hours for the primary endpoint
Primary endpoint
Reduction in right ventricular to left ventricular ratio at 48 hours
Result
Mean RV/LV ratio reduction at 48 hours was 0.52±0.37 with thrombectomy versus 0.24±0.40 with anticoagulation alone. Vital signs normalised earlier with thrombectomy, and major adverse event rates were comparable between arms.
Secondary endpoints
Time to normalisation of vital signs, major adverse events, bleeding
CAVT was superior to anticoagulation alone in reducing RV/LV ratio within 48 hours in patients with intermediate-high risk PE, accompanied by earlier normalization of vital signs and major adverse event rates comparable to those for anticoagulation.
The trial authors, in the published abstract
How it has aged
A hundred patients and a surrogate endpoint: RV/LV ratio is a reasonable physiological marker but it is not survival, and this trial is far too small to speak to mortality. Read alongside PEERLESS, where the composite favouring thrombectomy was likewise driven by intermediate outcomes rather than death, and PEITHO, which showed what happens when you finally power for hard endpoints.
Publications
Randomized Controlled Trial of Mechanical Thrombectomy With Anticoagulation Versus Anticoagulation Alone for Acute Intermediate-High Risk Pulmonary Embolism: Primary Outcomes From the STORM-PE Trial
Lookstein RA, Konstantinides SV, Weinberg I, et al. Randomized Controlled Trial of Mechanical Thrombectomy With Anticoagulation Versus Anticoagulation Alone for Acute Intermediate-High Risk Pulmonary Embolism: Primary Outcomes From the STORM-PE Trial. Circulation 2026 Jan 6;153(1):21-34.