Login Register Cart 0
Generic placeholder image

Current Respiratory Medicine Reviews

Editor-in-Chief

ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Review Article

Chronic Thromboembolic Pulmonary Hypertension

Author(s): Emory Buck, Sean Kearns, Talal Dahhan, Kishan S. Parikh, Richard A. Krasuski and Sudarshan Rajagopal*

Volume 20, Issue 3, 2024

Published on: 25 January, 2024

Page: [188 - 201] Pages: 14

DOI: 10.2174/011573398X269421231228051751

Price: $65

Abstract

While the majority of patients have complete resolution of their acute pulmonary embolism (PE) after an adequate course of anticoagulation, some patients remain symptomatic with evidence of chronic PE. Chronic Thromboembolic Pulmonary Hypertension (CTEPH) and Chronic Thromboembolic Pulmonary Disease (CTEPD) are terms that describe symptomatic patients with chronic thromboembolic occlusions of the pulmonary arteries with or without pulmonary hypertension, respectively. Here, we review the definitions, epidemiology, pathobiology, diagnosis and management of CTEPH. The chronic PE in CTEPH is essentially a scar in the pulmonary vasculature and is accompanied by a pulmonary arteriolar vasculopathy. Ventilation-perfusion scanning is the most sensitive screening test for CTEPH, and diagnosis must be confirmed by right heart catheterization (RHC). Treatment decisions require a multidisciplinary team and guidance from additional imaging, usually CT or pulmonary angiography. While pulmonary endarterectomy (PEA) to remove the chronic PE surgically is still the first-line treatment for appropriate candidates, there is an expanding role for balloon pulmonary angioplasty (BPA) and medical treatment, as well as multimodality treatment approaches that incorporate all of those options. New imaging modalities and treatment strategies hold the promise to improve our care and management of CTEPH patients in the future.

« Previous Next »
Graphical Abstract

[1]
Remy-Jardin M, Hutt A, Remy J. Chronic thromboembolic pulmonary disease and chronic thromboembolic pulmonary hypertension. Semin Respir Crit Care Med 2022; 43(6): 936-45.
[http://dx.doi.org/10.1055/s-0042-1755570] [PMID: 36307107]
[2]
Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2023; 61(1): 2200879.
[http://dx.doi.org/10.1183/13993003.00879-2022] [PMID: 36028254]
[3]
Saeedan MB, Bullen J, Heresi GA, Rizk A, Karim W, Renapurkar RD. Morphologic and functional dual-energy CT parameters in patients with chronic thromboembolic pulmonary hypertension and chronic thromboembolic disease. AJR Am J Roentgenol 2020; 215(6): 1335-41.
[http://dx.doi.org/10.2214/AJR.19.22743] [PMID: 32991219]
[4]
Nijkeuter M, Hovens MMC, Davidson BL, Huisman MV. Resolution of thromboemboli in patients with acute pulmonary embolism: A systematic review. Chest 2006; 129(1): 192-7.
[http://dx.doi.org/10.1378/chest.129.1.192] [PMID: 16424432]
[5]
Sanchez O, Helley D, Couchon S, et al. Perfusion defects after pulmonary embolism: Risk factors and clinical significance. J Thromb Haemost 2010; 8(6): 1248-55.
[http://dx.doi.org/10.1111/j.1538-7836.2010.03844.x] [PMID: 20236393]
[6]
Wartski M, Collignon MA. Incomplete recovery of lung perfusion after 3 months in patients with acute pulmonary embolism treated with antithrombotic agents. THESEE study group. tinzaparin ou heparin standard: Evaluation dans l’Embolie pulmonaire study. J Nucl Med 2000; 41(6): 1043-8.
[PMID: 10855632]
[7]
Pesavento R, Filippi L, Palla A, et al. Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 2017; 49(5): 1601980.
[http://dx.doi.org/10.1183/13993003.01980-2016] [PMID: 28546279]
[8]
McGuire WC, Alotaibi M, Morris TA, Kim NH, Fernandes TM. Chronic thromboembolic disease: Epidemiology, assessment with invasive cardiopulmonary exercise testing, and options for management. Struct Heart 2021; 5(2): 120-7.
[http://dx.doi.org/10.1080/24748706.2020.1861397]
[9]
Delcroix M, Torbicki A, Gopalan D, et al. ERS statement on chronic thromboembolic pulmonary hypertension. Eur Respir J 2021; 57(6): 2002828.
[http://dx.doi.org/10.1183/13993003.02828-2020] [PMID: 33334946]
[10]
Nilsson LT, Andersson T, Larsen F, Lang IM, Liv P, Söderberg S. Dyspnea after pulmonary embolism: A nation-wide population-based case–control study. Pulm Circ 2021; 11(4): 1-9.
[http://dx.doi.org/10.1177/20458940211046831] [PMID: 34616546]
[11]
Swietlik EM, Ruggiero A, Fletcher AJ, et al. Limitations of resting haemodynamics in chronic thromboembolic disease without pulmonary hypertension. Eur Respir J 2019; 53(1): 1801787.
[http://dx.doi.org/10.1183/13993003.01787-2018] [PMID: 30409818]
[12]
Guérin L, Couturaud F, Parent F, et al. Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Thromb Haemost 2014; 112(9): 598-605.
[http://dx.doi.org/10.1160/TH13-07-0538] [PMID: 24898545]
[13]
Leber L, Beaudet A, Muller A. Epidemiology of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: identification of the most accurate estimates from a systematic literature review. Pulm Circ 2021; 11(1): 1-12.
[http://dx.doi.org/10.1177/2045894020977300] [PMID: 33456755]
[14]
Kramm T, Wilkens H, Fuge J, et al. Incidence and characteristics of chronic thromboembolic pulmonary hypertension in Germany. Clin Res Cardiol 2018; 107(7): 548-53.
[http://dx.doi.org/10.1007/s00392-018-1215-5] [PMID: 29450722]
[15]
Ende-Verhaar YM, Cannegieter SC, Vonk Noordegraaf A, et al. Incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: A contemporary view of the published literature. Eur Respir J 2017; 49(2): 1601792.
[http://dx.doi.org/10.1183/13993003.01792-2016] [PMID: 28232411]
[16]
Golpe R, Pérez-de-Llano LA, Castro-Añón O, et al. Right ventricle dysfunction and pulmonary hypertension in hemodynamically stable pulmonary embolism. Respir Med 2010; 104(9): 1370-6.
[http://dx.doi.org/10.1016/j.rmed.2010.03.031] [PMID: 20418082]
[17]
Pengo V, Lensing AWA, Prins MH, et al. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 2004; 350(22): 2257-64.
[http://dx.doi.org/10.1056/NEJMoa032274] [PMID: 15163775]
[18]
Simonneau G, Hoeper MM. Evaluation of the incidence of rare diseases: Difficulties and uncertainties, the example of chronic thromboembolic pulmonary hypertension. Eur Respir J 2017; 49(2): 1602522.
[http://dx.doi.org/10.1183/13993003.02522-2016] [PMID: 28232419]
[19]
Valerio L, Mavromanoli AC, Barco S, et al. Chronic thromboembolic pulmonary hypertension and impairment after pulmonary embolism: The FOCUS study. Eur Heart J 2022; 43(36): 3387-98.
[http://dx.doi.org/10.1093/eurheartj/ehac206] [PMID: 35484821]
[20]
Delcroix M, Kerr K, Fedullo P. Chronic thromboembolic pulmonary hypertension. Epidemiology and risk factors. Ann Am Thorac Soc 2016; 13 (Suppl. 3): S201-6.
[http://dx.doi.org/10.1513/AnnalsATS.201509-621AS] [PMID: 27571001]
[21]
Alba GA, Atri D, Darbha S, et al. Chronic thromboembolic pulmonary hypertension: The bench. Curr Cardiol Rep 2021; 23(10): 141.
[http://dx.doi.org/10.1007/s11886-021-01572-6] [PMID: 34410515]
[22]
Bernard J, Yi ES. Pulmonary thromboendarterectomy: A clinicopathologic study of 200 consecutive pulmonary thromboendarterectomy cases in one institution. Hum Pathol 2007; 38(6): 871-7.
[http://dx.doi.org/10.1016/j.humpath.2006.11.017] [PMID: 17350667]
[23]
Privratsky JR, Newman PJ. PECAM-1: Regulator of endothelial junctional integrity. Cell Tissue Res 2014; 355(3): 607-19.
[http://dx.doi.org/10.1007/s00441-013-1779-3] [PMID: 24435645]
[24]
Kellermair J, Redwan B, Alias S, et al. Platelet endothelial cell adhesion molecule 1 deficiency misguides venous thrombus resolution. Blood 2013; 122(19): 3376-84.
[http://dx.doi.org/10.1182/blood-2013-04-499558] [PMID: 24081660]
[25]
Alias S, Redwan B, Panzenböck A, et al. Defective angiogenesis delays thrombus resolution: A potential pathogenetic mechanism underlying chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 2014; 34(4): 810-9.
[http://dx.doi.org/10.1161/ATVBAHA.113.302991] [PMID: 24526692]
[26]
Viswanathan G, Kirshner HF, Nazo N, et al. Single-cell analysis reveals distinct immune and smooth muscle cell populations that contribute to chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2023; 207(10): 1358-75.
[http://dx.doi.org/10.1164/rccm.202203-0441OC] [PMID: 36803741]
[27]
Bochenek M, Rosinus N, Lankeit M, et al. From thrombosis to fibrosis in chronic thromboembolic pulmonary hypertension. Thromb Haemost 2017; 117(4): 769-83.
[http://dx.doi.org/10.1160/TH16-10-0790] [PMID: 28150849]
[28]
Quarck R, Wynants M, Verbeken E, Meyns B, Delcroix M. Contribution of inflammation and impaired angiogenesis to the pathobiology of chronic thromboembolic pulmonary hypertension. Eur Respir J 2015; 46(2): 431-43.
[http://dx.doi.org/10.1183/09031936.00009914] [PMID: 26113681]
[29]
Remková A, Šimková I, Valkovičová T. Platelet abnormalities in chronic thromboembolic pulmonary hypertension. Int J Clin Exp Med 2015; 8(6): 9700-7.
[PMID: 26309645]
[30]
Yaoita N, Shirakawa R, Fukumoto Y, et al. Platelets are highly activated in patients of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 2014; 34(11): 2486-94.
[http://dx.doi.org/10.1161/ATVBAHA.114.304404] [PMID: 25169936]
[31]
Moser KM, Bioor CM. Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension. Chest 1993; 103(3): 685-92.
[http://dx.doi.org/10.1378/chest.103.3.685] [PMID: 8449052]
[32]
Wagenvoort CA. Pathology of pulmonary thromboembolism. Chest 1995; 107(1) (Suppl. 1): 10S-7S.
[http://dx.doi.org/10.1378/chest.107.1_Supplement.10S] [PMID: 7813322]
[33]
Dorfmüller P, Günther S, Ghigna MR, et al. Microvascular disease in chronic thromboembolic pulmonary hypertension: A role for pulmonary veins and systemic vasculature. Eur Respir J 2014; 44(5): 1275-88.
[http://dx.doi.org/10.1183/09031936.00169113] [PMID: 25142477]
[34]
Boulate D, Perros F, Dorfmuller P, et al. Pulmonary microvascular lesions regress in reperfused chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant 2015; 34(3): 457-67.
[http://dx.doi.org/10.1016/j.healun.2014.07.005] [PMID: 25123056]
[35]
Sadushi-Kolici R, et al. Subcutaneous treprostinil for the treatment of severe non-operable chronic thromboembolic pulmonary hypertension (CTREPH): A double-blind, phase 3, randomised controlled trial. Lancet Respir Med 2019; 7(3): 239-48.
[PMID: 30477763]
[36]
Ghofrani HA, D’Armini AM, Grimminger F, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med 2013; 369(4): 319-29.
[http://dx.doi.org/10.1056/NEJMoa1209657] [PMID: 23883377]
[37]
Ghofrani HA, Simonneau G, D’Armini AM, et al. Macitentan for the treatment of inoperable chronic thromboembolic pulmonary hypertension (MERIT-1): Results from the multicentre, phase 2, randomised, double-blind, placebo-controlled study. Lancet Respir Med 2017; 5(10): 785-94.
[http://dx.doi.org/10.1016/S2213-2600(17)30305-3] [PMID: 28919201]
[38]
Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J 2020; 41(4): 543-603.
[http://dx.doi.org/10.1093/eurheartj/ehz405] [PMID: 31504429]
[39]
Helmersen D, Provencher S, Hirsch AM, et al. Diagnosis of chronic thromboembolic pulmonary hypertension: A canadian thoracic society clinical practice guideline update. Can J Respir 2019; 3(4): 177-98.
[http://dx.doi.org/10.1080/24745332.2019.1631663]
[40]
Boon GJAM, Ende-Verhaar YM, Bavalia R, et al. Non-invasive early exclusion of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: The InShape II study. Thorax 2021; 76(10): 1002-9.
[http://dx.doi.org/10.1136/thoraxjnl-2020-216324] [PMID: 33758073]
[41]
Bonderman D, Wilkens H, Wakounig S, et al. Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir J 2008; 33(2): 325-31.
[http://dx.doi.org/10.1183/09031936.00087608] [PMID: 18799507]
[42]
Klok FA, Tesche C, Rappold L, et al. External validation of a simple non-invasive algorithm to rule out chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Thromb Res 2015; 135(5): 796-801.
[http://dx.doi.org/10.1016/j.thromres.2014.12.009] [PMID: 25746363]
[43]
Klok FA, Dzikowska-Diduch O, Kostrubiec M, et al. Derivation of a clinical prediction score for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. J Thromb Haemost 2016; 14(1): 121-8.
[http://dx.doi.org/10.1111/jth.13175] [PMID: 26509468]
[44]
Tunariu N, Gibbs SJR, Win Z, et al. Ventilation-perfusion scintigraphy is more sensitive than multidetector CTPA in detecting chronic thromboembolic pulmonary disease as a treatable cause of pulmonary hypertension. J Nucl Med 2007; 48(5): 680-4.
[http://dx.doi.org/10.2967/jnumed.106.039438] [PMID: 17475953]
[45]
He J, Fang W, Lv B, et al. Diagnosis of chronic thromboembolic pulmonary hypertension. Nucl Med Commun 2012; 33(5): 459-63.
[http://dx.doi.org/10.1097/MNM.0b013e32835085d9] [PMID: 22262242]
[46]
Remy-Jardin M, Ryerson CJ, Schiebler ML, et al. Imaging of pulmonary hypertension in adults: A position paper from the Fleischner Society. Eur Respir J 2021; 57(1): 2004455.
[http://dx.doi.org/10.1183/13993003.04455-2020] [PMID: 33402372]
[47]
Soler X, Hoh CK, Test VJ, Kerr KM, Marsh JJ, Morris TA. Single photon emission computed tomography in chronic thromboembolic pulmonary hypertension. Respirology 2011; 16(1): 131-7.
[http://dx.doi.org/10.1111/j.1440-1843.2010.01867.x] [PMID: 20920137]
[48]
Dong C, Zhou M, Liu D, Long X, Guo T, Kong X. Diagnostic accuracy of computed tomography for chronic thromboembolic pulmonary hypertension: A systematic review and meta-analysis. PLoS One 2015; 10(4): e0126985.
[http://dx.doi.org/10.1371/journal.pone.0126985] [PMID: 25923810]
[49]
Rajaram S, Swift AJ, Capener D, et al. Diagnostic accuracy of contrast-enhanced MR angiography and unenhanced proton MR imaging compared with CT pulmonary angiography in chronic thromboembolic pulmonary hypertension. Eur Radiol 2012; 22(2): 310-7.
[http://dx.doi.org/10.1007/s00330-011-2252-x] [PMID: 21887483]
[50]
Ende-Verhaar YM, Meijboom LJ, Kroft LJM, et al. Usefulness of standard computed tomography pulmonary angiography performed for acute pulmonary embolism for identification of chronic thromboembolic pulmonary hypertension: Results of the InShape III study. J Heart Lung Transplant 2019; 38(7): 731-8.
[http://dx.doi.org/10.1016/j.healun.2019.03.003] [PMID: 30962147]
[51]
Tamura M, Yamada Y, Kawakami T, et al. Diagnostic accuracy of lung subtraction iodine mapping CT for the evaluation of pulmonary perfusion in patients with chronic thromboembolic pulmonary hypertension: Correlation with perfusion SPECT/CT. Int J Cardiol 2017; 243: 538-43.
[http://dx.doi.org/10.1016/j.ijcard.2017.05.006] [PMID: 28526539]
[52]
Masy M, Giordano J, Petyt G, et al. Dual-energy CT (DECT) lung perfusion in pulmonary hypertension: Concordance rate with V/Q scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH). Eur Radiol 2018; 28(12): 5100-10.
[http://dx.doi.org/10.1007/s00330-018-5467-2] [PMID: 29846802]
[53]
Nakazawa T, Watanabe Y, Hori Y, et al. Lung perfused blood volume images with dual-energy computed tomography for chronic thromboembolic pulmonary hypertension: Correlation to scintigraphy with single-photon emission computed tomography. J Comput Assist Tomogr 2011; 35(5): 590-5.
[http://dx.doi.org/10.1097/RCT.0b013e318224e227] [PMID: 21926854]
[54]
Meinel FG, Graef A, Thierfelder KM, et al. Automated quantification of pulmonary perfused blood volume by dual-energy CTPA in chronic thromboembolic pulmonary hypertension. Röfo Fortschr Geb Röntgenstr Neuen Bildgeb Verfahr 2014; 186(2): 151-6.
[PMID: 23975878]
[55]
Takagi H, Ota H, Sugimura K, et al. Dual-energy CT to estimate clinical severity of chronic thromboembolic pulmonary hypertension: Comparison with invasive right heart catheterization. Eur J Radiol 2016; 85(9): 1574-80.
[http://dx.doi.org/10.1016/j.ejrad.2016.06.010] [PMID: 27501891]
[56]
Hinrichs JB, Marquardt S, von Falck C, et al. Comparison of C-arm computed tomography and digital subtraction angiography in patients with chronic thromboembolic pulmonary hypertension. Cardiovasc Intervent Radiol 2016; 39(1): 53-63.
[http://dx.doi.org/10.1007/s00270-015-1090-7] [PMID: 25828726]
[57]
Lasch F, Karch A, Koch A, et al. Comparison of MRI and VQ-SPECT as a screening test for patients with suspected CTEPH: CHANGE-MRI study design and rationale. Front Cardiovasc Med 2020; 7: 51.
[http://dx.doi.org/10.3389/fcvm.2020.00051] [PMID: 32328500]
[58]
Puebla-Aldama D, Cueto-Robledo G, Barragan-Martinez MP, et al. Review of functional status and hemodynamic parameters in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) with and without antiphospholipid syndrome (APLS). Curr Probl Cardiol 2023; 48(7): 101154.
[http://dx.doi.org/10.1016/j.cpcardiol.2022.101154] [PMID: 35192873]
[59]
Lee YH, Song GG. Direct oral anticoagulants versus warfarin in patients with antiphospholipid syndrome: A meta-analysis of randomized controlled trials. Lupus 2022; 31(11): 1335-43.
[http://dx.doi.org/10.1177/09612033221118463] [PMID: 35968627]
[60]
Connors JM. Thrombophilia testing and venous thrombosis. N Engl J Med 2017; 377(23): 2298.
[PMID: 29211668]
[61]
Narechania S, Renapurkar R, Heresi GA. Mimickers of chronic thromboembolic pulmonary hypertension on imaging tests: A review. Pulm Circ 2020; 10(1): 1-17.
[http://dx.doi.org/10.1177/2045894019882620] [PMID: 32257112]
[62]
Xi XY, Gao W, Gong JN, et al. Value of 18F-FDG PET/CT in differentiating malignancy of pulmonary artery from pulmonary thromboembolism: A cohort study and literature review. Int J Cardiovasc Imaging 2019; 35(7): 1395-403.
[http://dx.doi.org/10.1007/s10554-019-01553-5] [PMID: 30747369]
[63]
Association PH. PHCC - Center Criteria 2022.
[64]
Mayer E, Jenkins D, Lindner J, et al. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: Results from an international prospective registry. J Thorac Cardiovasc Surg 2011; 141(3): 702-10.
[http://dx.doi.org/10.1016/j.jtcvs.2010.11.024] [PMID: 21335128]
[65]
Brenot P, Jaïs X, Taniguchi Y, et al. French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Eur Respir J 2019; 53(5): 1802095.
[http://dx.doi.org/10.1183/13993003.02095-2018] [PMID: 31023842]
[66]
Guth S, D’Armini AM, Delcroix M, et al. Current strategies for managing chronic thromboembolic pulmonary hypertension: Results of the worldwide prospective CTEPH registry. ERJ Open Res 2021; 7(3): 00850-2020.
[http://dx.doi.org/10.1183/23120541.00850-2020] [PMID: 34409094]
[67]
Guth S, Mayer E, Prüfer D, Wiedenroth CB. Pulmonary endarterectomy: Technique and pitfalls. Ann Cardiothorac Surg 2022; 11(2): 180-8.
[http://dx.doi.org/10.21037/acs-2021-pte-185] [PMID: 35433367]
[68]
Madani M, Mayer E, Fadel E, Jenkins DP. Pulmonary endarterectomy. Patient selection, technical challenges, and outcomes. Ann Am Thorac Soc 2016; 13 (Suppl. 3): S240-7.
[http://dx.doi.org/10.1513/AnnalsATS.201601-014AS] [PMID: 27571005]
[69]
Vuylsteke A, Sharples L, Charman G, et al. Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): A randomised controlled trial. Lancet 2011; 378(9800): 1379-87.
[http://dx.doi.org/10.1016/S0140-6736(11)61144-6] [PMID: 22000135]
[70]
Skoro-Sajer N, Marta G, Gerges C, et al. Surgical specimens, haemodynamics and long-term outcomes after pulmonary endarterectomy. Thorax 2014; 69(2): 116-22.
[http://dx.doi.org/10.1136/thoraxjnl-2013-203746] [PMID: 24052543]
[71]
Olman MA, Auger WR, Fedullo PF, Moser KM. Pulmonary vascular steal in chronic thromboembolic pulmonary hypertension. Chest 1990; 98(6): 1430-4.
[http://dx.doi.org/10.1378/chest.98.6.1430] [PMID: 2245685]
[72]
Kratzert WB, Boyd EK, Saggar R, Channick R. Critical care of patients after pulmonary thromboendarterectomy. J Cardiothorac Vasc Anesth 2019; 33(11): 3110-26.
[http://dx.doi.org/10.1053/j.jvca.2019.03.005] [PMID: 30948200]
[73]
Moser KM, Metersky ML, Auger WR, Fedullo PF. Resolution of vascular steal after pulmonary thromboendarterectomy. Chest 1993; 104(5): 1441-4.
[http://dx.doi.org/10.1378/chest.104.5.1441] [PMID: 8222803]
[74]
Archibald CJ, Auger WR, Fedullo PF, et al. Long-term outcome after pulmonary thromboendarterectomy. Am J Respir Crit Care Med 1999; 160(2): 523-8.
[http://dx.doi.org/10.1164/ajrccm.160.2.9808109] [PMID: 10430723]
[75]
Mayer E. Surgical and post-operative treatment of chronic thromboembolic pulmonary hypertension. Eur Respir Rev 2010; 19(115): 64-7.
[http://dx.doi.org/10.1183/09059180.00007409] [PMID: 20956168]
[76]
Cannon JE, Su L, Kiely DG, et al. Dynamic risk stratification of patient long-term outcome after pulmonary endarterectomy. Circulation 2016; 133(18): 1761-71.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.115.019470] [PMID: 27052413]
[77]
Condliffe R, Kiely DG, Gibbs JSR, et al. Improved outcomes in medically and surgically treated chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2008; 177(10): 1122-7.
[http://dx.doi.org/10.1164/rccm.200712-1841OC] [PMID: 18292468]
[78]
Madani MM, Auger WR, Pretorius V, et al. Pulmonary endarterectomy: Recent changes in a single institution’s experience of more than 2,700 patients. Ann Thorac Surg 2012; 94(1): 97-103.
[http://dx.doi.org/10.1016/j.athoracsur.2012.04.004] [PMID: 22626752]
[79]
Delcroix M, Lang I, Pepke-Zaba J, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension. Circulation 2016; 133(9): 859-71.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.115.016522] [PMID: 26826181]
[80]
Kawakami T, Ogawa A, Miyaji K, et al. Novel angiographic classification of each vascular lesion in chronic thromboembolic pulmonary hypertension based on selective angiogram and results of balloon pulmonary angioplasty. Circ Cardiovasc Interv 2016; 9(10): e003318.
[http://dx.doi.org/10.1161/CIRCINTERVENTIONS.115.003318] [PMID: 27729418]
[81]
Poch DS, Mahmud E, Patel M, et al. Patient selection for balloon pulmonary angioplasty: Six-year results from a high volume PTE surgical center. Pulm Circ 2022; 12(4): e12148.
[http://dx.doi.org/10.1002/pul2.12148] [PMID: 36325508]
[82]
Feinstein JA, Goldhaber SZ, Lock JE, Ferndandes SM, Landzberg MJ. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation 2001; 103(1): 10-3.
[http://dx.doi.org/10.1161/01.CIR.103.1.10] [PMID: 11136677]
[83]
Mizoguchi H, Ogawa A, Munemasa M, Mikouchi H, Ito H, Matsubara H. Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Interv 2012; 5(6): 748-55.
[http://dx.doi.org/10.1161/CIRCINTERVENTIONS.112.971077] [PMID: 23192917]
[84]
Sugimura K, Fukumoto Y, Satoh K, et al. Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 2012; 76(2): 485-8.
[http://dx.doi.org/10.1253/circj.CJ-11-1217] [PMID: 22185711]
[85]
Ogawa A, Satoh T, Fukuda T, et al. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Circ Cardiovasc Qual Outcomes 2017; 10(11): e004029.
[http://dx.doi.org/10.1161/CIRCOUTCOMES.117.004029] [PMID: 29101270]
[86]
Aoki T, Sugimura K, Tatebe S, et al. Comprehensive evaluation of the effectiveness and safety of balloon pulmonary angioplasty for inoperable chronic thrombo-embolic pulmonary hypertension: Long-term effects and procedure-related complications. Eur Heart J 2017; 38(42): 3152-9.
[http://dx.doi.org/10.1093/eurheartj/ehx530] [PMID: 29029023]
[87]
Anand V, Frantz RP, DuBrock H, et al. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: Initial single-center experience. Mayo Clin Proc Innov Qual Outcomes 2019; 3(3): 311-8.
[http://dx.doi.org/10.1016/j.mayocpiqo.2019.06.006] [PMID: 31485569]
[88]
Kawakami T, Matsubara H, Shinke T, et al. Balloon pulmonary angioplasty versus riociguat in inoperable chronic thromboembolic pulmonary hypertension (MR BPA): An open-label, randomised controlled trial. Lancet Respir Med 2022; 10(10): 949-60.
[http://dx.doi.org/10.1016/S2213-2600(22)00171-0] [PMID: 35926544]
[89]
Jaïs X, Brenot P, Bouvaist H, et al. Balloon pulmonary angioplasty versus riociguat for the treatment of inoperable chronic thromboembolic pulmonary hypertension (RACE): A multicentre, phase 3, open-label, randomised controlled trial and ancillary follow-up study. Lancet Respir Med 2022; 10(10): 961-71.
[http://dx.doi.org/10.1016/S2213-2600(22)00214-4] [PMID: 35926542]
[90]
Bunclark K, Newnham M, Chiu YD, et al. A multicenter study of anticoagulation in operable chronic thromboembolic pulmonary hypertension. J Thromb Haemost 2020; 18(1): 114-22.
[http://dx.doi.org/10.1111/jth.14649] [PMID: 31557382]
[91]
Simonneau G, D’Armini AM, Ghofrani HA, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: A long-term extension study (CHEST-2). Eur Respir J 2015; 45(5): 1293-302.
[http://dx.doi.org/10.1183/09031936.00087114] [PMID: 25395036]
[92]
Marra AM, Halank M, Benjamin N, et al. Right ventricular size and function under riociguat in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension (the RIVER study). Respir Res 2018; 19(1): 258.
[http://dx.doi.org/10.1186/s12931-018-0957-y] [PMID: 30567595]
[93]
Fernandes TM, Poch DS, Auger WR. Treatment of chronic thromboembolic pulmonary hypertension: The role of medical therapy and balloon pulmonary angioplasty. Methodist DeBakey Cardiovasc J 2016; 12(4): 205-12.
[http://dx.doi.org/10.14797/mdcj-12-4-205] [PMID: 28289495]
[94]
Cabrol S, Souza R, Jais X, et al. Intravenous epoprostenol in inoperable chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant 2007; 26(4): 357-62.
[http://dx.doi.org/10.1016/j.healun.2006.12.014] [PMID: 17403477]
[95]
Skoro-Sajer N, Bonderman D, Wiesbauer F, et al. Treprostinil for severe inoperable chronic thromboembolic pulmonary hypertension. J Thromb Haemost 2007; 5(3): 483-9.
[http://dx.doi.org/10.1111/j.1538-7836.2007.02394.x] [PMID: 17319903]
[96]
Ogo T, Shimokawahara H, Kinoshita H, et al. Selexipag for the treatment of chronic thromboembolic pulmonary hypertension. Eur Respir J 2022; 60(1): 2101694.
[http://dx.doi.org/10.1183/13993003.01694-2021] [PMID: 34824052]
[97]
Jaïs X, D’Armini AM, Jansa P, et al. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol 2008; 52(25): 2127-34.
[http://dx.doi.org/10.1016/j.jacc.2008.08.059] [PMID: 19095129]
[98]
Escribano-Subias P, Bendjenana H, Curtis PS, Lang I, Noordegraaf AV. Ambrisentan for treatment of inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Pulm Circ 2019; 9(2): 1-3.
[http://dx.doi.org/10.1177/2045894019846433] [PMID: 30957635]
[99]
Ghofrani HA, Schermuly RT, Rose F, et al. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 2003; 167(8): 1139-41.
[http://dx.doi.org/10.1164/rccm.200210-1157BC] [PMID: 12684251]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy