Background: Pulmonary embolisms present a growing challenge in healthcare, with traditional treatments often carrying significant risks such as severe bleeding, blood pressure fluctuations, arrhythmias, and clot recurrences, despite the effectiveness of traditional systemic clot-dissolving therapy.This study analyzes the efficacy and safety of the novel minimally invasive EKOS-Lysis procedure as an innovative solution to mitigate risks and enhance treatment success for pulmonary embolisms, particularly in intermediate high-risk patients.The procedure entails ultrasound-guided catheter lysis intervention, which utilizes ultrasound waves to reduce the clot and involves the localized injection of the lysis drug.The objective of this study is to improve the effectiveness, safety, and comprehension of pulmonary embolism management, providing valuable insights that may redesign approaches to this life-threatening condition, while simultaneously aiming to evaluate the efficacy and safety of this novel procedure in treating pulmonary embolisms across various patient subgroups, focusing on its benefits and risks. The study seeks to identify the subgroup of patients exhibiting the most favorable short-term outcomes.With the pharmacological therapeutic analysis, potential interactions will be highlighted between the thrombolytic therapy used in EKOS-Lysis and chronic therapy routinely taken by patients, focusing on their impact on the overall outcomes.The objective is to assess the overall effectiveness and safety of the procedure by comparing it to existing data on standardized thrombolytic management. Material and methods: A retrospective study is conducted using a substantial dataset extracted from 100 patient files, categorized as intermediate high-risk for pulmonary embolism. Patient eligibility is assessed through a protocol-based review of individual medical records. Comprehensive inclusion criteria are established to evaluate each patient's clinical characteristics and history.The collected data are organized into a structured Excel database to facilitate systematic analysis. Biostatistical analysis is employed to assess the significance of differences and relationships within the dataset. Results are systematically compared between stratified groups and international data reported by literature. Results: The expected results based on the hypothesis are anticipated to suggest several promising outcomes. It is anticipated that improved short-term outcomes will be observed, characterized by various parameters such as decreased duration of hospitalization and reduced incidence, or absence, of post-treatment complications. Additionally, the analysis aims to determine the most and least effective anticoagulation and lysis drug for specific patient subgroups, providing valuable insights into optimized treatment strategies tailored to individual needs.It is expected that the findings will indicate a superior overall outcome in comparison to standardized systematically injected lysis therapy. This comparative analysis will shed light on the potential advantages of the EKOS-Lysis procedure over traditional treatment approaches. Conclusions: In conclusion, this study will investigate the efficacy and safety of the EKOS-Lysis procedure as an alternative to traditional systemic thrombolytic therapy for managing pulmonary embolism, in intermediate high-risk patients. Anticipated results suggest that EKOS-Lysis may offer superior short-term outcomes, optimal anticoagulant choices for specific patient subgroups, and overall improved efficacy compared to standardized thrombolytic therapy. These findings have the potential to reshape current treatment paradigms and enhance the management of pulmonary embolism. [ABSTRACT FROM AUTHOR]