
Ep. 51 Advancements in Pulmonary Embolism Algorithm and Management with Dr. David Dexter and Dr. Maya Serhal
BackTable CardiologyShow Notes
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 byImperative Care https://www.imperativecare.com/
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Timestamps00:00 - Introduction02:03 - PE Response Workflow05:32 - Symphony Device07:07 - Sizing and Blood Loss10:00 - Multi-Port Hemodynamics14:45 - Procedure Endpoints17:01 - IVUS Guided Strategy20:02 - ProHelix and Lollipopping25:48 - Case Studies34:12 - Closing Thoughts
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More about this episodeThe 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 Embolismhttps://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-PEhttps://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.126.016573
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