Multicenter longitudinal observational ambispective (retrospective cases from 2014 and prospective from 2018 onwards) cohort study. The registry recruits a series of consecutive patients admitted for moderate-high risk or high-risk pulmonary embolism (according to 2019 European Society of Cardiology guidelines) treated invasively. This study aims to describe the acute management of the safety and effectiveness of different percutaneous interventions for acute pulmonary embolism.

Inclusion Criteria:

• adult patients (aged 18 years old or older)
• confirmed diagnosis of acute PE (on computed tomography or echocardiogram plus pulmonary angiography)
• high-risk PE or intermediate-high risk according to ESC risk stratification in the 2019 guidelines (briefly, elevated cardiac biomarkers [troponin or N-terminal pro-B-type natriuretic peptide], and right ventricle to left ventricle ratio > 0.9 [on computed tomography or echocardiogram], and PE severity index III to IV or simplified PE severity index=1
• eligibility for catheter-directed intervention

Exclusion Criteria:

• unconfirmed diagnosis of PE
• undefined risk stratification, and
• PE with uncertain chronology or beyond seven days of symptom initiation.

Consecutive patients admitted for moderate-high risk or high-risk PE and treated invasively with any kind of catheter-directed intervention.