Purpose: To evaluate the use of suction thrombectomy in patients with high and intermediate high-risk pulmonary embolism Methodology: A retrospective analysis of 13 patients undergoing Inari Thrombectomy for PE at a tertiary centre was conducted between 2023 and 2025. All patients followed a standardised anti-thrombotic regime and surveillance protocol. Primary outcomes include technical success, survival, and peri-procedural complications. Secondary outcomes include cardiac function and residual clot burden.    Results: The average patient age was 62.1 years (54% female), 54% were classified as high risk, while 69% presented with a shock index >0.7; half of those were normotensive. 4 patients (31%) required Inari thrombectomy for subacute to chronic thrombus that did not respond to CDT with AngioJet. Two patients had active malignancy. Technical success was 100%. The mean procedure duration was 71 minutes (±18.1). 31% of patients did not require ICU admission; for the ones that did, 38% required inotropes, and one required positive pressure ventilation with a mean ICU stay of 1.8 days.  There were no procedural complications, no access or bleeding complications, and the mean EBL was 23 ml (0-200ml). Survival at 48 hours and 4 weeks was 100%. The median length of stay post-procedure was 4 days (range, 1-55 days). At 4-week follow-up, CTPA demonstrated either complete resolution or minor residual thrombus in 83% of patients, with 77% of patients having returned to their pre-morbid exercise tolerance. Echocardiography at 48 hrs and 4 weeks demonstrated improved RV function with normal or mild pulmonary hypertension (mean RV systolic pressure 35.5 ± 8.5mmHg). All-cause mortality was 0% at a median follow-up of 6 months (1-12 months).     Conclusion: Inari mechanical thrombectomy provides a safe, effective alternative to thrombolysis for intermediate- and high-risk PE with proven superiority in subacute and chronic thrombus.