PLAT and pulmonary embolism: In the European ULTIMA (Ultrasound Accelerated Thrombolysis of Pulmonary Embolism) trial of 59 patients with submassive PE, ultrasound-facilitated and catheter-directed low-dose fibrinolysis plus anticoagulation used a higher dose of t-PA (20 mg), demonstrated a 0% incidence of major bleeding, improved RV function with a 30% difference in the RV/LV ratio, and reduced pulmonary artery pressure (using right heart catheter) from baseline to 24 h to a greater extent than anticoagulation alone [7].