Pulmonary embolism thrombectomy use increases by more than 700%
New analysis of Medicare data shows a major increase for both arterial and venous thrombectomy claims for venous thromboembolic disease filed between 2017 and 2022, according to a new article in the Journal of the American College of Radiology (JACR).[1]
Medicare claims submitted from January 2017 to December 2022 showed a 712% increase in arterial thrombectomy (AT) for pulmonary embolism (PE) and a 137% increase in venous thrombectomy (VT) for deep vein thrombosis (DVT). The study was supported by the Society of Interventional Radiology (SIR) to help reveal trends in vascular thrombectomy.
“The growth of arterial thrombectomy for PE is reflective of the fact we now have very safe ways of endovascular treatment for PE that we did not have 10 years ago,” explained Julie Bulman, MD, the lead author of the study and an interventional radiologist with Beth Israel Deaconess Medical Center in Boston, in a statement from SIR.
The publication comes just after PE thrombectomy received a major endorsement in the pivotal, late-breaking STORM-PE trial at the 2025 Transcatheter Cardiovascular Therapeutics (TCT) meeting last week. That trial showed positive outcomes for treating intermediate-risk PE patients with invasive thrombectomy rather than the standard of care using thrombolytics alone. PE interventions have seen wider discussion in sessions at TCT in recent years, and new data from this trial are answering questions that will likely inform new PE treatment guidelines. There has been growing interest in recent years in more invasive therapy to clear PE clots more quickly to improve outcomes.
The new analysis reinforces the hunch that the more invasive therapy is already being embraced in the real world.
Vascular surgeons dominate the AT space, mainly performed for peripheral arterial disease indications. Bulman said they filed 41% of AT claims, followed by interventional cardiology (35%) and interventional radiology (IR) (17%). But the data show IR AT claims grew 47% over five years while cardiology shrunk 19%, showing a change in who is performing the therapy.
Endovascular thrombectomy to treat DVT is led by interventional radiology, making up 34% of VT Medicare claims, followed by vascular surgery (29%) and interventional cardiology (20%). Vascular surgery showed a 47% increase in filed VT claims over the study period.
“Endovascular care is truly a shared space, and it is important to know what specialties are performing these procedures so all key players can be at the table,” said Bulman.
She said this is especially important data to know when it comes to establishing standards, guidelines and reimbursement rates. It is also important to know which specialties are performing the treatments to ensure access to care.
“These devices can be expensive, so if you are trying to figure out how to offer this service in your workplace, partnering with other endovascular specialists in your hospital can help advocate for new technologies,” Bulman said.
The researchers also found outpatient hospital facilities continue to be the main location patients receive vascular thrombectomy, accounting for 76% for AT and 78% for VT procedures. The study found office-based labs (OBLs) are also seeing increases for these procedures, but they currently only account for 5% of claims. Bulman explained this trend is being driven by better anticoagulation techniques used in emergency settings, which are allowing patients to seek follow up care in an outpatient settings if thrombolytic therapy alone is not working.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]