The PEERLESS Study

NCT ID: NCT05111613

Last Updated: 2025-11-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

692 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-14

Study Completion Date

2024-04-11

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

A prospective, multicenter, randomized controlled trial of the FlowTriever System compared to Catheter-Directed Thrombolysis (CDT) for use in the treatment of acute pulmonary embolism. The trial includes a non-randomized cohort of subjects with an absolute contraindication to thrombolysis.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pulmonary Embolism Pulmonary Thromboembolism

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

PE pulmonary embolism thrombectomy FlowTriever CDT Catheter-Directed Thrombolysis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Randomized Controlled Trial Cohort - FlowTriever Arm

Mechanical thrombectomy for pulmonary embolism using the FlowTriever System.

Group Type ACTIVE_COMPARATOR

FlowTriever System

Intervention Type DEVICE

Mechanical thrombectomy for pulmonary embolism

Randomized Controlled Trial Cohort - Catheter-Directed Thrombolysis Arm

Catheter-Directed Thrombolysis for pulmonary embolism (any commercially available CDT system)

Group Type ACTIVE_COMPARATOR

Catheter-Directed Thrombolysis

Intervention Type DEVICE

Catheter-Directed Thrombolysis for pulmonary embolism (any commercially available CDT system)

Non-Randomized Absolute Contraindication to Thrombolytics Cohort

Mechanical thrombectomy for pulmonary embolism using the FlowTriever System.

Group Type OTHER

FlowTriever System

Intervention Type DEVICE

Mechanical thrombectomy for pulmonary embolism

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Catheter-Directed Thrombolysis

Catheter-Directed Thrombolysis for pulmonary embolism (any commercially available CDT system)

Intervention Type DEVICE

FlowTriever System

Mechanical thrombectomy for pulmonary embolism

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Subjects must meet each of the following criteria to be included in the study:

* Age ≥ 18 years
* Echo, computed tomographic pulmonary angiography (CTPA), or pulmonary angiographic evidence of any proximal filling defect in at least one main or lobar pulmonary artery
* Including ALL of the following: Clinical signs and symptoms consistent with acute PE, or PESI class III-V, or sPESI ≥1; AND Hemodynamically stable AND; RV dysfunction on echocardiography or CT; AND Any one or more of the following present at the time of diagnosis: Elevated cardiac troponin levels; History of heart failure; History of chronic lung disease; Heart rate ≥110 beats per minute; SBP \<100mmHg; Respiratory rate ≥30 breaths per minute; O2 saturation \<90%; Syncope related to PE; Elevated Lactate
* Intervention planned to begin within 72 hours of the later of either: confirmed PE diagnosis; OR if transferring from another hospital, arrival at the treating hospital
* Symptom onset within 14 days of confirmed PE diagnosis

Exclusion Criteria

Subjects will be excluded from the study for any of the following criteria:

* Unable to anticoagulate with heparin, enoxaparin or other parenteral antithrombin
* Index presentation with hemodynamic instability that are part of the high-risk PE definition in the ESC Guidelines 2019, including ANY of the following: cardiac arrest; OR systolic BP \< 90 mmHg or vasopressors required to achieve a BP ≥90 mmHg despite adequate filling status, AND end-organ hypoperfusion; OR systolic BP \< 90 mmHg or systolic BP drop ≥40 mmHg, lasting longer than 15 min and not caused by new-onset arrhythmia, hypovolemia, or sepsis
* Known sensitivity to radiographic contrast agents that, in the Investigator's opinion, cannot be adequately pre-treated
* Imaging evidence or other evidence that suggests, in the opinion of the Investigator, the patient is not appropriate for catheter-based intervention (e.g. inability to navigate to target location, clot limited to segmental/subsegmental distribution, predominately chronic clot)
* Patient has right heart clot in transit identified at baseline screening
* Life expectancy \< 30 days (e.g. stage 4 cancer or severe COVID-19 infection), as determined by the Investigator
* Current participation in another drug or device study that, in the Investigator's opinion, would interfere with participation in this study
* Current or history of chronic thromboembolic pulmonary hypertension (CTEPH) or chronic thromboembolic disease (CTED) diagnosis, per ESC 2019 guidelines
* Invasive systolic PA pressure ≥70 mmHg prior to study device entering the body
* Administration of bolus or drip/infusion thrombolytic therapy or mechanical thrombectomy for the index PE event within 48 hours prior to enrollment
* Ventricular arrhythmias refractory to treatment at the time of enrollment
* Known to have heparin-induced thrombocytopenia (HIT)
* Subject has any condition for which, in the opinion of the Investigator, participation would not be in the best interest of the subject (e.g., compromise the well-being or that could prevent, limit, or confound the protocol-specified assessments). This includes a contraindication to use of FlowTriever or CDT System (for example, EKOS System) per local approved labeling
* Subject has previously completed or withdrawn from this study
* Patient unwilling or unable to conduct the follow up visits per protocol.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Inari Medical

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Wissam Jaber, MD

Role: PRINCIPAL_INVESTIGATOR

Emory University

Carin Gonsalves, MD

Role: PRINCIPAL_INVESTIGATOR

Thomas Jefferson University

Stefan Stortecky, MD

Role: PRINCIPAL_INVESTIGATOR

Bern University Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Loma Linda University Health

Loma Linda, California, United States

Site Status

Providence St. Joseph Orange

Orange, California, United States

Site Status

Huntington Hospital

Pasadena, California, United States

Site Status

University of Colorado Hospital

Aurora, Colorado, United States

Site Status

Radiology and Imaging Associates

Lakeland, Florida, United States

Site Status

Baptist Health South Florida

Miami, Florida, United States

Site Status

Sarasota Memorial Hospital

Sarasota, Florida, United States

Site Status

Tallahassee Memorial Hospital

Tallahassee, Florida, United States

Site Status

University of South Florida Tampa General Hospital

Tampa, Florida, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Ascension Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States

Site Status

Advocate Christ Medical Center

Oak Lawn, Illinois, United States

Site Status

Ascension St. Vincent Hospital - Indianapolis

Indianapolis, Indiana, United States

Site Status

Norton Healthcare

Louisville, Kentucky, United States

Site Status

Brigham and Womens Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Center

Boston, Massachusetts, United States

Site Status

Ascension St. John Hospital

Detroit, Michigan, United States

Site Status

CentraCare St. Cloud Hospital

Saint Cloud, Minnesota, United States

Site Status

University of Mississippi Medical Center

Jackson, Mississippi, United States

Site Status

Saint Luke's Hospital of Kansas City

Kansas City, Missouri, United States

Site Status

Saint Louis University

St Louis, Missouri, United States

Site Status

Virtua Lourdes

Camden, New Jersey, United States

Site Status

Hackensack University Medical Center

Hackensack, New Jersey, United States

Site Status

Northwell Health

Bay Shore, New York, United States

Site Status

Gates Vascular Institute

Buffalo, New York, United States

Site Status

NewYork-Presbyterian Columbia University Irving Medical Center

New York, New York, United States

Site Status

University of Rochester Medical Center

Rochester, New York, United States

Site Status

University of North Carolina Health

Chapel Hill, North Carolina, United States

Site Status

Novant Health New Hanover Regional Medical Center

Wilmington, North Carolina, United States

Site Status

Summa Akron City Hospital

Akron, Ohio, United States

Site Status

Mercy Health West

Cincinnati, Ohio, United States

Site Status

University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

Site Status

OhioHealth Riverside Methodist Hospital

Columbus, Ohio, United States

Site Status

St. Luke's University Hospital

Bethlehem, Pennsylvania, United States

Site Status

AHN Saint Vincent Hospital

Erie, Pennsylvania, United States

Site Status

UPMC Harrisburg

Harrisburg, Pennsylvania, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Thomas Jefferson University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

UPMC Presbyterian

Pittsburgh, Pennsylvania, United States

Site Status

MUSC Health University Medical Center

Charleston, South Carolina, United States

Site Status

Spartanburg Regional Healthcare System

Spartanburg, South Carolina, United States

Site Status

Lexington Medical Center

West Columbia, South Carolina, United States

Site Status

HCA TriStar Centennial Medical Center

Nashville, Tennessee, United States

Site Status

Ascension Saint Thomas Hospital

Nashville, Tennessee, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

HCA Medical City Heart and Spine

Dallas, Texas, United States

Site Status

Houston Methodist Hospital

Houston, Texas, United States

Site Status

Memorial Hermann Medical Center

Houston, Texas, United States

Site Status

Methodist Main Hospital

San Antonio, Texas, United States

Site Status

Sentara Norfolk General Hospital

Norfolk, Virginia, United States

Site Status

Providence Sacred Heart Medical Center

Spokane, Washington, United States

Site Status

Ascension St. Elizabeth Hospital

Appleton, Wisconsin, United States

Site Status

Gundersen Health System

La Crosse, Wisconsin, United States

Site Status

Aurora St. Luke's Medical Center

Milwaukee, Wisconsin, United States

Site Status

Universtitaetsklinikum Dusseldorf

Düsseldorf, , Germany

Site Status

Herzzentrum Leipzig

Leipzig, , Germany

Site Status

Marien Hospital Wesel GmbH

Wesel, , Germany

Site Status

Inselspital - Universitätsspital Bern

Bern, , Switzerland

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands United States Germany Switzerland

References

Explore related publications, articles, or registry entries linked to this study.

Gonsalves CF, Gibson CM, Stortecky S, Alvarez RA, Beam DM, Horowitz JM, Silver MJ, Toma C, Rundback JH, Rosenberg SP, Markovitz CD, Tu T, Jaber WA. Randomized controlled trial of mechanical thrombectomy vs catheter-directed thrombolysis for acute hemodynamically stable pulmonary embolism: Rationale and design of the PEERLESS study. Am Heart J. 2023 Dec;266:128-137. doi: 10.1016/j.ahj.2023.09.002. Epub 2023 Sep 12.

Reference Type BACKGROUND
PMID: 37703948 (View on PubMed)

Jaber WA, Gonsalves CF, Stortecky S, Horr S, Pappas O, Gandhi RT, Pereira K, Giri J, Khandhar SJ, Ammar KA, Lasorda DM, Stegman B, Busch L, Dexter DJ 2nd, Azene EM, Daga N, Elmasri F, Kunavarapu CR, Rea ME, Rossi JS, Campbell J, Lindquist J, Raskin A, Smith JC, Tamlyn TM, Hernandez GA, Rali P, Schmidt TR, Bruckel JT, Camacho JC, Li J, Selim S, Toma C, Basra SS, Bergmark BA, Khalsa B, Zlotnick DM, Castle J, O'Connor DJ, Gibson CM; PEERLESS Committees and Investigators*. Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis in the Management of Intermediate-Risk Pulmonary Embolism: Primary Results of the PEERLESS Randomized Controlled Trial. Circulation. 2025 Feb 4;151(5):260-273. doi: 10.1161/CIRCULATIONAHA.124.072364. Epub 2024 Oct 29.

Reference Type RESULT
PMID: 39470698 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

21-002

Identifier Type: -

Identifier Source: org_study_id