علاج ارتفاع ضغط الدم الرئوي الخثاري المزمن غير القابل للجراحة تقنيًا

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.
• Treprostinil s.c. may be considered in patients in WHO-FC III-IV who have inoperable CTEPH or persistent/recurrent PH after PEA.
• Off-label use of drugs approved for PAH may be considered in symptomatic patients who have inoperable CTEPH.
• In patients with inoperable CTEPH, a combination of sGC stimulator/PDE5i, ERA, or parenteral prostacyclin analogues may be considered.
• In patients with CTEPH who are candidates for BPA, medical therapy should be considered prior to the intervention.
• Most experts accept achieving a good functional class (WHO-FC I-II) and/or normalization or near normalization of haemodynamics at rest, obtained at RHC 3-6 months post-procedure (PEA or last BPA), and improvement in quality of life.