Abstract
A 69-year-old male presented to the emergency department with sudden shortness of breath, three weeks after recovering from a COVID-19 infection. Despite having no significant prior medical history, the patient rapidly deteriorated, suffering a cardiac arrest. He was resuscitated and diagnosed with a massive saddle pulmonary embolism, confirmed via echocardiogram and computed tomography pulmonary angiography (CTPA). After systemic thrombolysis with alteplase failed to stabilize his condition, mechanical thrombectomy was performed. Catheter-guided aspiration of the thrombus led to substantial hemodynamic improvement. The patient recovered and was discharged four days later. This case highlights the importance of rapid intervention in managing massive pulmonary embolism and the efficacy of percutaneous thrombectomy in cases of hemodynamic instability despite thrombolysis.