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Aims: Catheter-directed treatment (CDT) of acute pulmonary embolism (PE) is entering a growth phase in Europe following a steady increase in the USA in the past decade, but the potential economic impact on European healthcare systems remains unknown., Methods and Results: We built two statistical models for the monthly trend of proportion of CDT among patients with severe (intermediate- or high-risk) PE in the USA. The conservative model was based on admission data from the National Inpatient Sample (NIS) 2016-20 and the model reflecting increasing access to advanced treatment from the PERT™ national quality assurance database registry 2018-21. By applying these models to the forecast of annual PE-related hospitalizations in Germany, we calculated the annual number of severe PE cases and the expected increase in CDT use for the period 2025-30. The NIS-based model yielded a slow increase, reaching 3.1% (95% confidence interval 3.0-3.2%) among all hospitalizations with PE in 2030; in the PERT-based model, increase would be steeper, reaching 8.7% (8.3-9.2%). Based on current reimbursement rates, we estimated an increase of annual costs for PE-related hospitalizations in Germany ranging from 15.3 to 49.8 million euros by 2030. This calculation does not account for potential cost savings, including those from reduced length of hospital stay., Conclusion: Our approach and results, which may be adapted to other European healthcare systems, provide a benchmark for healthcare costs expected to result from CDT. Data from ongoing trials on clinical benefits and cost savings are needed to determine cost-effectiveness and inform reimbursement decisions., Competing Interests: Conflict of interest: K.M, Kl.K., Ka.K., H.B., T.N., C.A., I.T.F., T.M.T., K.C., M.L., J.R., and L.V.: no disclosures; B.K.: AngioDynamics, Penumbra, Viz.ai, and Dexcom (consultant); R.P.R.: BMS and Janssen (institutional research support); Abbott, Dova, Inari, Janssen, and Penumbra (advisory/consultant); STORM-PE National Lead Investigator, Penumbra; The PERT Consortium™ President; J.M.M.: AngioDynamics, Penumbra, Argon Medical, Pavmed, Auxetics, Innova Vascular, Inquis Medical, Retriever Medical, and Boston Scientific (consultant); K.R.: Abbott Vascular, AngioDynamics, Auxetics, Becton Dickinson, Boston Scientific, Contego, Imperative Care/TRUVIC, Johnson and Johnson Biosense Webster, Medtronic, Neptune Medical, Philips, SurModics, and Terumo (consultant/advisory board); Access Vascular, Aerami, Althea Medical, Auxetics, Contego, Endospan, Imperative Care/TRUVIC, Innova Vascular, InspireMD, JanaCare, Magneto, MedAlliance, Neptune Medical, Orchestra, ProSomnus, Sealonix, Shockwave, Skydance, Summa Therapeutics, Thrombolex, Valcare, Vantis Vascular, Vasorum, and VuMedi (equity or stock options); NIH, Abiomed, Boston Scientific, Novo Nordisk, Penumbra, and Gettinge-Atrium (research grants via institution); The National PERT Consortium™, Board of Directors; S.B. Boston Scientific, Medtronic, Bayer, and Sanofi (institutional research support by Board); Boston Scientific, Penumbra, and Viatris (personal fees/honoraria); R.N.C.: Penumbra, Steering Committee; J.S.G.: advisor and research fees to the institution from Boston Scientific and Inari Medical; equity in Endovascular Engineering; R.A.L.: Boston Scientific and Medtronic (advisory board); Penumbra, Abbott Vascular, Neptune Medical, Bard Vascular, Cordis, Biosense Webster, Becton Dickinson, SurModics, and Abbott Vascular (speakers bureau); Philips Healthcare, Spectranetics, Terumo, Boston Scientific, Inari, Penumbra, Ethicon, Vesper, and Black Swan (research support); Imperative Vascular, Summa Vascular, Innova Vascular, and Thrombolex (equity shareholder); L.H.: MSD and Janssen (personal lecture/consultant fees); S.V.K.: Bayer AG, Boston Scientific, Daiichi-Sankyo, LumiraDx, and Penumbra (personal lecture/advisory fees and research grants to institution); MSD, Pfizer, and Bristol-Myers Squibb (personal lecture/advisory fees); E.A.S.: NIH/NHLBI K23HL150290, Food & Drug Administration, and SCAI (funding); Abbott, BD, Boston Scientific, Cook, Medtronic, and Philips (grants to institution); Abbott, BD, Boston Scientific, Cagent, Conavi, Cook, Cordis, InfraRedx, Medtronic, Philips, Recor, Shockwave, and VentureMed (speaking/consulting)., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)