Here is the design of a clinical trial:

Official Title: Low Dose Thrombolysis, Ultrasound Assisted Thrombolysis or Heparin for Intermediate High Risk Pulmonary Embolism

Included conditions:
- Pulmonary Embolism

Study Armgroups:
- {'label': 'USAT + low dose thrombolysis', 'type': 'ACTIVE_COMPARATOR', 'description': 'UltraSound Assisted Thrombolysis (USAT) with low dose thrombolysis (20 mg of rtPA, Alteplase) over 6 hours plus unfractionated heparin (UFH) or low molecular weight heparin (LMWH) within 12 hours of randomization', 'interventionNames': ['Drug: Alteplase 20 Mg Powder for Solution for Injection Vial', 'Device: Ultrasound assisted Thrombolysis']}
- {'label': 'Low dose thrombolysis', 'type': 'ACTIVE_COMPARATOR', 'description': 'Intravenous low dose thrombolysis (20 mg of rtPA, Alteplase) over 6 hours plus UFH or low molecular weight heparin (LMWH).', 'interventionNames': ['Drug: Alteplase 20 Mg Powder for Solution for Injection Vial']}
- {'label': 'Heparin alone', 'type': 'NO_INTERVENTION', 'description': 'UFH or low molecular weight heparin (LMWH) only (with option for conventional thrombolysis according to local protocols for hemodynamic deterioration)'}

Interventions:
- {'type': 'DRUG', 'name': 'Alteplase 20 Mg Powder for Solution for Injection Vial', 'description': 'Low dose alteplase delivered IV or bu Ultrasound Assisted Thrombolysis device', 'armGroupLabels': ['Low dose thrombolysis', 'USAT + low dose thrombolysis']}
- {'type': 'DEVICE', 'name': 'Ultrasound assisted Thrombolysis', 'description': 'Ultrasound assisted thrombolysis (USAT)', 'armGroupLabels': ['USAT + low dose thrombolysis']}

Primary Outcomes:
- {'measure': 'Reduction in Miller score comparing low dose thrombolysis and heparin alone groups', 'description': 'Reduction in Miller Score and on follow-up (48-96 h) CT pulmonary Angiography comparing low-dose rtPA (±USAT) to UFH/LMWH group (p\\<0.01, N=210)', 'timeFrame': 'at 48 to 96 hours post randomization'}
- {'measure': 'Reduction i Miller score comparing low dose thrombolysis by iv and by USATgroups', 'description': 'reduction in Miller Score and on follow-up (48-96 h) CT pulmonary Angiography comparing low-dose rtPA by USAT to iv, p\\<0.04, N=140)', 'timeFrame': 'at 48 to 96 hours post randomization'}

Please estimate the sample size based on the assumption: 
The trial has two co-primary endpoints sharing a combined α-level of 0.05. For the first co-primary endpoint, a power of 0.8 is achieved with 165 patients and a power of 0.90 with 210 patients, with an α of 0.01. For the second co-primary endpoint, a power of 0.9 is achieved with 140 patients and an α-level of 0.04, assuming a 22% or greater reduction in RMS in the USAT group compared to the IV group.
Sample size {14}
        The power of the trial is calculated as two co-primary endpoints, sharing a combined Î±-level of 0.05.
        A mean RMS of 18âÂ±â7 is expected at baseline [14]. A variance component model (proc mixed, SAS enterprise ver. 8,4, Cary, NC) was applied.
        The treatment effect is expected to be a reduction in RMS of 2 points (11%) in the UFH/LMWH group after 48â96Â h (extrapolation from [13]), whereas the reduction in RMS in both thrombolysis groups is expected to be 6 points (33%) [13]. The net effect of thrombolysis by USAT is expected to be similarly efficacious.
        The first co-primary endpoint evaluates the effect of the intervention of thrombolysis comparing RMS in the UFH/LMWH group to RMS in the combined groups of low-dose thrombolysis with or without USAT (1:2).
        Planning inclusion of 165 (3*55) patients will give a power of 0.8 whereas 210 (3*70) patients will give a power of 0.90, with an Î± of 0.01 for the primary endpoint.
        The second co-primary endpoint evaluates the effect of low-dose thrombolysis administered by USAT or IV will yield a power of 0.9 by the inclusion of 140 patients (1:1) with an Î±-level of 0.04, assuming a 22% reduction or greater reduction in RMS in the USAT group compared the IV group.
        The trial is planning to include 210 patients, with 70 patients assigned to UFH/LMWH, 70 to low-dose thrombolysis without USAT, and 70 assigned to low-dose thrombolysis with USAT initiated within a mean of 12Â h from randomization.