Acute pulmonary thromboembolism is a common condition with non-specific findings, high mortality, and multiple therapeutic options. Death in patients with acute massive pulmonary thromboembolism is caused by sudden circulatory collapse as a consequence of obstructed pulmonary blood flow. Initial therapy must therefore be directed toward quickly restoring pulmonary circulation. In a number of cases, thrombolytic therapy may fail to achieve this therapeutic goal in time. Percutaneous catheter treatment may represent an additional option for high-risk patients. In this paper, different concepts of such treatment include pigtail catheter thrombectomy and embolus aspiration with PTCA guiding catheter are described.