This study aims to compare the effectiveness and safety of three treatment strategies (Anticoagulation, Thrombolysis, and Mechanical Thrombectomy) for patients with intermediate-high risk acute pulmonary embolism (PE) in a real-world setting. Approximately 1,300 patients will be enrolled across multiple centers in China. Patients will be followed for 90 days to assess mortality, heart function recovery, bleeding risks, and quality of life. The results will help guide personalized treatment decisions and healthcare policy.
Age unlimited (reflecting real-world population).
Symptom duration of acute PE ≤ 14 days.
Confirmed acute PE by CTPA involving main or lobar pulmonary arteries.
RV/LV ratio ≥ 0.9 (by CT or Echocardiography).
Already received thrombolysis or mechanical thrombectomy for the current episode prior to enrollment.
Unable to obtain baseline or follow-up CTPA imaging.
(Note: Unlike strict RCTs, patients with cancer, renal insufficiency, or advanced age are NOT excluded to ensure real-world representativeness).