Experimental: Catheter-Directed Therapy (CDT) plus Anticoagulation

Participants will receive CDT consisting of mechanical thrombectomy (MT) or intrathrombus catheter-directed thrombolysis (CDL) using FDA-cleared devices for pulmonary embolism (PE). The exact technique and devices used will be at the discretion of the endovascular physician, within parameters defined by the PE-TRACT Manual of Operations (MOP) and accepted standard care. Before and after CDT, patients will receive standard PE therapy as in the no-CDT Arm.

Active_comparator: No Catheter-Directed Therapy (No-CDT)

Standard anticoagulant therapy (FDA-approved regimen) for the treatment of PE.