Chronic Thromboembolic Pulmonary Disease

Overview

Journal Eur Respir J

Specialty Pulmonary Medicine

Date 2024 Aug 29

PMID 39209473

Authors

Nick H Kim

Andrea M DArmini

Marion Delcroix

Xavier Jais

Mitja Jevnikar

Michael M Madani

Hiromi Matsubara

Massimiliano Palazzini

Christoph B Wiedenroth

Gerald Simonneau

David P Jenkins

Affiliations

Soon will be listed here.

Abstract

Chronic thromboembolic pulmonary hypertension is a complication of pulmonary embolism and a treatable cause of pulmonary hypertension. The pathology is a unique combination of mechanical obstruction due to failure of clot resolution, and a variable degree of microvascular disease, that both contribute to pulmonary vascular resistance. Accordingly, multiple treatments have been developed to target the disease components. However, accurate diagnosis is often delayed. Evaluation includes high-quality imaging modalities, necessary for disease confirmation and for appropriate treatment planning. All patients with chronic thromboembolic pulmonary disease, and especially those with pulmonary hypertension, should be referred to expert centres for multidisciplinary team decision on treatment. The first decision remains assessment of operability, and the best improvement in symptoms and survival is achieved by the mechanical therapies, pulmonary endarterectomy and balloon pulmonary angioplasty. With the advances in multimodal therapies, excellent outcomes can be achieved with 3-year survival of >90%.

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