Acute high-risk PE with contraindications to ST or after ineffective ST Acute intermediate-high-risk PE with clinical and hemodynamic deterioration during anticoagulant treatment -clinical, imaging, and/or laboratory data indicating worsening of PE (Table 4) Acute intermediate-high-risk PE without clinical and hemodynamic improvement despite anticoagulant therapy-clinical, imaging, and/or laboratory data indicating persistence of PE (Table 4) Acute intermediate-high-risk PE with absolute contraindications to ST Acute PE with a thrombus in the RV, the so-called thrombus in transit, including the presence of a thrombus passing through the PFO/ASD Acute PE with coexisting symptoms of paradoxical embolism such as acute myocardial infarction, ischemic stroke Acute high-risk or intermediate-high-risk PE in a pregnant patient Acute nonthrombotic PE (e.g., fat embolism, amniotic fluid, iatrogenic embolism) Acute PE superimposed on chronic thromboembolic pulmonary hypertension