Blood clots represent a significant burden to the healthcare system. Venous thromboembolism (VTE) includes blood clots that form in the deep veins of the legs, as well as those in the lungs. A clot that travels from the leg veins to the lungs is called a pulmonary embolism (PE), a gravely serious condition. VTE affects 900,000 Americans per year, resulting in up to 100,000 premature deaths, and is estimated to cost hospital systems up to $10 billion annually.1,2
The latest advanced therapies could minimize hospital resource use, improve patient care and quality of life, and reduce hospital stays. But evidence gaps in the medical community have limited the number of patients who may benefit. While standardized protocols have been instrumental in improving outcomes in STEMI and stroke care, guidelines for PE — the third leading cause of cardiovascular death3 — have changed little over the years.
Standardizing care paths to facilitate prompt diagnosis and expanding access to current treatment options may help reduce disparities in how blood clots are managed. New evidence should spur an evolution in care protocols for PE. The landmark trial, STORM-PE, is the first level 1 evidence comparing traditional anticoagulation to advanced therapy — specifically Computer Assisted Vacuum Thrombectomy (CAVT™) — plus anticoagulation. STORM-PE found superior reduction in right heart strain among intermediate-high risk PE patients treated with CAVT, with a similar risk profile. These findings mark a pivotal milestone for PE treatment and will ultimately advance the paradigm of care.
In the interim, one successful strategy to get patients optimal care faster could be the implementation of a formal response team to treat VTE, or a pulmonary embolism response team (PERT). A PERT helps to standardize care delivery, identifies and risk stratifies patients, and provides multidisciplinary considerations for care. Studies have suggested that implementing a PERT can shorten hospital stays, decrease hospital costs as much as 34%, and lower hospital mortality by up to 16%.4
Identifying Gaps in VTE Care Guidance
A recent survey of 269 healthcare professionals caring for VTE patients, including interventionalists and non-interventionalists, found gaps in VTE care guidance. The survey was conducted by the Get Out the Clot campaign.i
The survey reveals that more than 50% of physicians surveyed say they do not have a formal response team at their institution, such as a VTE response team or PERT.5 Just 56% of those interventionalists reported that their protocols provide “clear direction based on PE risk beyond medical management,” and approaches vary, even for patients with the same risk profile.5 Similar gaps were found for lower extremity venous thrombus care.
A Health Economics Case for Advanced Therapy
Catheter directed therapies offer a new opportunity to improve VTE care. The conventional therapy, anticoagulation, prevents clots from propagating but does not remove the clot. Formal response teams enable access to advanced therapies that can remove the clot quickly and safely by helping to identify the patients who would benefit most.
CAVT, a minimally invasive procedure used to remove blood clots from the veins and arteries, is one of these new therapies. CAVT employs microprocessor clot detection algorithms to help remove clot efficiently while distinguishing between clot and patent flow which is designed to minimize blood loss.
A series of retrospective analyses were performed to compare healthcare resource utilization and outcomes of patients using CAVT versus traditional therapies across a variety of conditions. Sg2, a Vizient company, analyzed resource use and health outcomes of 2,060 1:1 propensity score matched patients with intermediate-risk PE discharged over a three year period, treated with CAVT (Lightning 12 and Lightning Flash 1.0) compared to traditional treatment modalities, including anticoagulation, catheter-directed thrombolysis (CDL) and other forms of mechanical thrombectomy.ii
Compared to the other traditional PE therapies, CAVT was associated with:
- 3.4 times lower composite complications without increasing mortality6,iii
- 25% to 35% shorter total hospital length of stay6,iv,v
- 25% to 30% higher rate of patients discharged to home6
Sg2 also provided a retrospective analysis of 808 1:1 propensity score matched patients comparing CAVT (Lightning 12 and Lightning Flash 1.0) to anticoagulation alone for lower extremity venous thrombus.vi
The researchers found that CAVT was associated with:
- 17% shorter total hospital length of stay7,iv,v
- 40% higher rate of patients discharged to home7
- Half the likelihood of needing long-term care and/or a skilled nursing facility7
- Significantly fewer patients needing post-discharge home health support7
- Lower composite complications7,iii
The Future of VTE Care Is Now
VTE specialists are recognizing that advanced therapies can transform blood clot care. The Get Out the Clot survey found that 79% of interventionalists believe that thrombectomy can improve patient outcomes and 73% want to see expanded use of thrombectomy and CAVT for PE patients at their hospitals.5
The adoption of these technologies shows promise for both patient outcomes and hospital economics. Hospital systems have much to gain from eliminating the gaps in care guidance that drive such disparities.
Shruthi Narayan is president of Penumbra Inc., the world’s leading thrombectomy company focused on developing the most innovative technologies for challenging medical conditions such as ischemic stroke, venous thromboembolism, and acute limb ischemia.
Dr. James F. Benenati, M.D., FSIR is a board-certified interventional radiologist and serves as the Chief Medical Officer of Penumbra Inc.
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1 Data and Statistics on Venous Thromboembolism. Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, January 27, 2025, https://www.cdc.gov/blood-clots/data-research/facts-stats/index.html.
2 Beckman M, Hooper WC, Critchley S, Ortel T. Venous thromboembolism: a public health concern. Am J Prev Med. 2010;38(4 Suppl):S495-501.
3 Martin KA, Molsberry R, Cuttica MJ, Desai KR, Schimmel DR, Khan SS. Time Trends in Pulmonary Embolism Mortality Rates in the United States, 1999 to 2018. J Am Heart Assoc. 2020;9(17):e016784. doi:10.1161/JAHA.120.016784.
4 Annabathula R, Dugan A, Bhalla V, Davis GA, Smyth SS, Gupta VA. Value-based assessment of implementing a Pulmonary Embolism Response Team (PERT). J Thromb Thrombolysis. 2021 Jan;51(1):217-225. doi: 10.1007/s11239-020-02188-3. PMID: 32542527; PMCID: PMC8325945.
5 Get Out The Clot. Survey Results. Get Out The Clot. https://www.getouttheclot.com/survey-results/. Accessed October 22, 2025.
6 Patel P, Dohad S, Moriarty J, et al. Healthcare resource utilization and outcomes among patients with intermediate-risk pulmonary embolism treated with computer-assisted vacuum
thrombectomy versus other treatment modalities. Presented at: VIVA (Vascular InterVentional Advances) 2024; 04 November 2024; Las Vegas, NV.
7 Desai K, Hoots G, Ryu RK, et al. Computer-assisted vacuum thrombectomy vs. anticoagulation for iliofemoral deep vein thrombosis management: a comparative analysis of hospital and post-hospital outcomes. Presented at: SIR (Society of Interventional Radiology) 2025; Nashville, TN.
i The Get Out the Clot campaign is an educational initiative that includes Penumbra Inc., along with The American Venous Forum Foundation, International Society on Thrombosis and Haemostasis (ISTH®), National Blood Clot Alliance, The PERT Consortium™, and Society for Vascular Medicine
ii The researchers excluded patients with high-risk PE, septic PE, patients who had two treatments in one day, and patients whose discharge status limited the ability to track the outcomes.
iii Composite complications is defined by Vizient and in this study includes: In Hospital Stroke, GI Hemorrhage Prevention, Post Operative Infection, Hospital Acquired AMI, Readmit for Infection Due to Previous Care, Readmit for other complications of internal device/Implant/Graph, Readmit for Other Surgical Wound Complications, Infection/Inflammation Due to Internal Device/Implant/Graph, Post Operative Shock, Aspiration/Pneumonia, C-Diff.
iv Statistically significant relative to anticoagulation alone.
v Total hospital length of stay is measured in days.
vi Patient cohort was segmented for patients who have iliofemoral venous thrombus. Researchers excluded patients with a primary diagnosis of PE, who had more than one procedure on the same or preceding day, those who had systemic thrombolysis use, and cases coded as inferior vena cava and superior vena cava, popliteal, tibial, and peroneal were excluded.
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