CLOT Conversations

Acute PE: New Categories, Faster Decisions and What Changes in Practice

Thrombosis Canada Season 2 Episode 34

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Dr. Lana Castellucci and Dr. Kerstin de Wit join CLOT Conversations to discuss the 2026 guideline for the evaluation and management of acute pulmonary embolism in adults and what its recommendations mean for clinical practice.

The conversation explores the new A–E clinical categories for acute PE, including how to recognize patients whose condition may be deteriorating despite not meeting traditional criteria for high-risk PE. The discussion also covers the role of PE response teams (PERT), outpatient versus inpatient management, the recommendation for low-molecular-weight heparin over IV unfractionated heparin when parenteral therapy is required, and patient selection for systemic thrombolysis and catheter-directed therapies.

The guests also address a common patient question about flying after PE, important evidence gaps, and a fundamental clinical message: avoid unnecessary delays in anticoagulation while determining next steps.

Creager MA, Barnes GD, Giri J, et al. 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2026 Mar 24;153(12):e977-e1051. doi: 10.1161/CIR.0000000000001415. 

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001415

Hosts: David Airdrie, Dr. Jameel Abdulrehman and Dr. Maha Othman.

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