Pulmonary Embolism — Saddle Embolus

A 58-year-old man with a 10-day history of immobilization following orthopedic surgery presents with sudden-onset dyspnea, pleuritic chest pain, and syncope. CT pulmonary angiography (CTPA) is performed. The structure marked **A** in the diagram shows a large filling defect at the bifurcation of the main pulmonary artery, extending into both right and left pulmonary arteries. Which of the following management strategies is most appropriate for this patient's condition?