Newly released HI-PEITHO trial data are among the highlights of this year’s venous programming at the 2026 Charing Cross (CX) Symposium (CX 2026; 21–23 April, London, UK), which also takes a look at open surgery for deep venous reconstruction after failed endovascular interventions. Sessions will run all day tomorrow in Theatre 2.
The fast-evolving landscape of pulmonary embolism (PE) care forms a central plinth of the CX 2026 venous programme, buttressed by updates from three key trials in the space.
STORM-PE, HI-PEITHO and STRIKE-PE feature during the venous and lymphatic consensus series of sessions on Wednesday, which kicks off with Aditya Sharma (Charlotte, USA) giving an overview of real-world risk stratification in patients with acute PE.
Robert Lookstein (New York, USA) introduces the first of the major trials, STORM-PE, a randomised controlled trial (RCT) that assesses the value of computer-assisted vacuum thrombectomy (CAVT) for intermediate-high-risk PE. Late last year, Lookstein revealed that the use of mechanical thrombectomy CAVT using the 16Fr Lightning Flash system (Penumbra), with anticoagulation achieves superior reduction in right heart strain compared to anticoagulation therapy alone in patients with acute intermediate-high-risk PE during the 2025 Transcatheter Cardiovascular Therapeutics (TCT) conference (25–28 October, San Francisco, USA).
John Moriarty (Los Angeles, USA) presents one-year functional outcomes and quality-of-life data from STRIKE-PE, a single-arm, prospective, multicentre, ongoing trial looking at CAVT patients treated using the 16Fr catheter.
Stavros Konstantinides (Mainz, Germany) delivers an update on the recently published HI-PETHO RCT, which looked at patients who underwent ultrasound-facilitated, catheter- directed fibrinolysis for acute PE and found that they had significantly better outcomes than those who received standard systemic anticoagulants. First presented at the American College of Cardiology’s Annual Scientific Session (ACC.26; 28–30 March, New Orleans, USA), the study showed that the targeted catheter-based approach reduced early PE-related death, circulatory collapse or PE recurrence by more than 60%.
Stephen Black (London, UK), CX executive board member, said the 2026 rundown is packed with variety, with the PE management session laser-focused on key recent developments on the space. “CX 2026 continues to develop the focus we have had on pulmonary embolism, which is a growing area of treatment for many clinicians worldwide,” he said. “And this year in particular, we are going to have a real focus on the data that starts to bring us towards consensus, which is the theme of CX 2026. There are three trial updates we will get: STORM-PE, STRIKE-PE and HI-PEITHO, which all add to the evidence base we are now starting to see building in PE, which really gives us a clear direction of travel and a clear evidence base to make decisions for our patients.”
Elsewhere, the deep venous session is led by CX co-chair Erin Murphy (Charlotte, USA), who considers the role of mechanical thrombectomy in venous disease, asking ‘Progress, victory or both?’ The session will also hear from Baris Ozdemir (Bristol, UK) who will provide an update on the European Society for Vascular Surgery (ESVS) Venous Registry (EVeR).
“In addition to the focus on PE, we have also got the usual programme highlights everyone has come to expect from CX,” continued Black. “We have focused this year on building out a sequence of virtual cases and case discussion-based presentations, and we’ll see several cases covering the full breadth of these treatments, including a highlight for me on complex reconstruction done by my fellow executive board member Manj Gohel [Cambridge, UK], which highlights that vascular interventions are not all endovascular these days and that we still need to have open skills.”
Pelvic venous disorders also take centre stage, with Black himself leading the session dedicated to the topic with a talk focused on differentiating ‘Nutcracker’ syndrome from clinically relevant disease. The same segment will also see an edited case from Aleksandra Jaworucka-Kaczorowska (Gorzów Wielkopolski, Poland) focused on management strategy after unsuccessful ‘bottom-up’ treatment of pelvic origin varicosities with ultrasound-guided foam sclerotherapy.
“This is an area of some controversy, and, with this year’s theme, we are trying to demonstrate some consensus around treatment strategies for pelvic venous disorders in 2026 and I’m sure there will be some valuable lessons to learn,” commented Black. “Of course, it wouldn’t be CX without some debate and this year’s venous programme has a debate around the role of first rib resection after thrombus removal for upper limb deep vein thrombosis [DVT] and I have no doubt we will have an entertaining discussion on its role.” The debate takes place between Andrew Garnham (Wolverhampton, UK) and Gohel under the proposition: ‘Early first rib resection should be routine after thrombus removal for upper extremity DVT’. Garnham will argue for and Gohel against, with the debate concluding the second of two deep venous sessions.
