Do you consider thrombocytopenia a contraindication for fibrinolytic therapy for a massive PE?  

If one has access to mechanical thrombectomy devices and operators, they should be considered before systemic thrombolytics unless the massive PE is causing imminent danger to the patient/patient is going to code/die, in which case the risk of dying from said PE is higher than potential bleeding eve...

Agree. MT is the preferred modality, as it can be done with AC. But obviously it’s a code or dying situation, then ST may be needed. ECMO is another option that can be done as an alternative to ST. Can consider low-dose ST, depending on how sick the patient is and how fast the drug needs to go...