علاج ارتفاع ضغط الدم الرئوي التخثري المزمن عند عدم إمكانية الجراحة تقنياً

References

DOI: 10.1093/eurheartj/ehac237

• Riociguat is recommended for symptomatic patients with inoperable CTEPH or persistent/recurrent PH after PEA
• BPA is recommended in patients who are technically inoperable or have residual PH after PEA and distal obstructions amenable to BPA
• Lifelong, therapeutic doses of anticoagulation are recommended in all patients with CTEPH
• VKAs are recommended by experts, and are most widely used as background therapy for patients with CTEPH.
• More recently, NOACs have more frequently been used as alternatives to VKAs, again, lacking evidence from RCTs.
• In patients with CTEPH and antiphospholipid syndrome, anticoagulation with VKAs is recommended
• General measures recommended for PAH also apply to CTEPH, including supervised exercise training, which is effective and safe in inoperable CTEPH patients, as well as early after PEA.