PurposeTo determine treatment preferences among endovascular and medical physicians who manage acute submassive pulmonary embolism (PE). Materials and MethodsFrom July through August 2016, 83 sites across the United States were surveyed, and 60 completed the survey. Endovascular and medical physicians were asked to rate their predilection for catheter-directed thrombolysis (CDT) on a 5-point scale and for systemic thrombolysis (ST) as “yes” or “no” in seven case scenarios of submassive PE. A CDT score ≥ 4 was considered to represent a predilection for CDT. Mean scores were used to compare CDT preferences between physicians. Percentages of physicians who preferred CDT or ST were calculated. P values < .05 were considered statistically significant. ResultsAcross all scenarios (numbered S1–S7) combined, endovascular physicians had a significantly higher CDT score (mean, 3.52) than medical physicians (mean, 3.01; P < .0001). Scenario-by-scenario analysis revealed that the mean CDT score was significantly higher for endovascular physicians (S1, 4.25; S2, 3.72; S3, 2.82; S4, 2.68; S5, 3.45; S6, 3.67; S7, 4.02) compared with medical physicians (S1, 3.62 [P < .001]; S2, 3.18 [P < .001]; S3, 2.45 [P = .001]; S4, 2.37 [P = .011]; S5, 2.97 [P < .001]; S6, 3.20 [P < .001]; S7, 3.53 [P < .001]). Overall, a significantly higher percentage of endovascular physicians (56.7%) indicated a predilection for CDT compared with medical physicians (37.9%; P < .001). Also, a significantly higher percentage of physicians, regardless of specialty, indicated a predilection for CDT (47.2%) than did for ST (5.3%; P < .0001). ConclusionsEndovascular physicians exhibited a greater predilection for CDT to treat acute submassive PE compared with their medical colleagues. Endovascular and medical physicians seemed to more frequently choose CDT than ST.